Obesity, type 2 diabetes and risk factors linked to poor diet, is the root cause behind increased death rates from
coronavirus according to UK study
AUT nutritionist Dr Caryn Zinn joins other international scientists to call for public health messaging on healthy diet
to reduce Covid 19 riskObesity, type 2 diabetes and metabolic syndrome associated with an up to 10-fold increase risk in death from COVID-19Ultra-processed food which makes up half of British diet blamed as primary culpritOnly 1 in 8 adults are metabolically healthyDietary changes can rapidly reduce risk of health complications and can potentially send type 2 diabetes into remission
within weeksInternational experts in medicine, dietetics and nutrition call for immediate update on public health messaging to eat
whole nutritious food to rapidly reduce risk of COVID-19 complications and potentially save hundreds and thousands of
lives
Obesity, type 2 diabetes and a cluster of risk factors, all linked to poor diet is the root cause behind increased
mortality from COVID -19
Writing in European Scientist, NHS Consultant Cardiologist and Professor of Evidence Based Medicine Dr Aseem Malhotra calls on public health
messaging to be urgently updated in the light of COVID-19 to ensure people are eating nutritious whole foods in an
attempt to reduce risk and subsequent death rates from the virus.
Drawing on UK data he notes that 72.7% of patients admitted to ICU are overweight or obese and that those with the
related metabolic syndrome have a tenfold increase in mortality from the virus.
Referring to US data where obesity levels are similar to the UK he notes that only 1 in 8 people are metabolically
healthy including less than 1 in 3 of “normal” weight.
With lockdown seeing Brits stocking up on ready-made meals, a leading Cardiologist says urgent changes must be made
nationally to rapidly change public health outcomes.
Dr Aseem Malhotra, NHS Consultant Cardiologist and Professor of Evidence Based Medicine, who has long campaigned against
sugary and ultra-processed food, says his findings, backed up internationally by leading doctors and nutritionists and
data coming in from every country affected by the Covid-19 outbreak, can no longer be ignored.
“What is staggering is that looking at all the data, it is irrefutable that metabolic disease is the leading cause of
mortality from Covid-19. This covers much of what we are already being told, that outcomes for patients suffering from
type 2 diabetes, heart disease and high blood pressure are far worse than in otherwise healthy adults. What is not being
spelled out is that poor diet and obesity is behind this.”
Yet he says that key changes to the way we eat can have significant effects WITHIN WEEKS, reducing blood pressure and
even reversing type 2 diabetes.
“By immediately cutting out sugar and ultra-processed food and preparing fresh meals, the impact on health can be seen
in just a matter of weeks.”
“We have always been far too cautious in the UK in rolling out a massive public health campaign to get people eating
properly when we have known for over a decade that obesity-related illness is the biggest factor behind poor health and
hospital admissions in the UK”
“Now we find ourselves in a public health crisis brought on by Covid-19, and can see clearly obesity and diet related
disease is behind a significant increase in the risk of hospitalisation and death. With people at home catering for
themselves every single night while this virus rampages through the country, the message is not just clear, it is
urgent. The general public need to be told IMMEDIATELY by official sources to cut out sugar, refined carbohydrates and
junk food and switch to a whole food diet abundant in vegetables, fruits, nuts, seeds, dairy and plenty of protein from
pulses, fish, meat, and eggs, to improve their health within weeks to help protect themselves if they contract the novel
coronavirus.”
Writing in European Scientist he concludes , “Given the speed at which health markers for metabolic disease improve from
dietary interventions, an equally strong if not more significant population health message should now be to “eat real
food, protect the NHS and save lives.” Such implementation backed by policy changes may not just save hundreds and
potentially thousands of lives around the world in the coming months but given the high likelihood of another
international viral pandemic in the next decade a healthier population and a subsequently more manageable health service
will be much better equipped to handle what would then be a smaller mortality peak on the next occasion. Hopefully if
and when that occurs a lockdown will not be required.”EXPERT REACTIONCaryn Zinn, senior lecturer and dietitian, Auckland University of Technology,Head of Research - School of Sport & Recreation, (021 924 314)
“The best we can do to prevent getting COVID-19 or to reduce its virulence if you do get it is to have a strong immune
system and good metabolic health. To achieve both of these, it’s critical to eat whole unprocessed foods that promote a
stable blood sugar – of course alongside other lifestyle behaviours such as getting enough sleep, sunshine (where
possible),regular exercise, engaging with friends and family (easily done on-line) and managing stress.
The problem is, in high stress-times, when it comes to food, many turn to highly processed, packaged food for comfort.
Now is the worst possible time for such choices. As the government is trying new things some mere endorsement of eating
healthy wholefood from our leaders should be mandatory. It always matters to look after your weight, and your metabolic
health, but now’s likely the most important time ever to do this”.Tim Spector, Professor of genetic epidemiology, King’s College, London and author of the Diet Myth
"Obesity and poor diet is emerging as one of the biggest risk factors for a severe response to Covid-19 infection that
can no longer be ignored."
Robert Lustig, Professor of paediatric endocrinology at the University of California, San Francisco and chairman of
institute of responsible nutrition
"I've heard COVID-19 referred to a beast, because it doesn't distinguish. In point of fact, it doesn't distinguish who
it infects. But it does distinguish who it kills. Other than the elderly, it's those who are Black, obese, and/or have
pre-existing conditions. What distinguished these three demographics? Ultra- Processed food. Because ultra -processed
food sets you up for inflammation, which COVID-19 is happy to exploit. Just another way processed food kills. Time to
rethink your menu."Hanno Pijl, Professor of Diabetes at the University of Leiden, The Netherlands
"In my opinion, Aseem Malhotra again conveys a powerful and important message, not only in the context of the current
health crisis, but for the benefit of general (public) health as well. Avoiding junk and eating whole nutritious food is
fundamental to reversing the staggering prevalence of chronic metabolic disease, and there’s no better time to start
than now’Dr James DiNicolantonio
Cardiovascular research scientist
St Luke’s Mid-America Heart Institute
“Dr Aseem Malhotra sheds light on the real elephant in the room with COVID-19 and that is the people who are most
susceptible to this virus, besides the elderly, are those individuals who are overweight or obese. Not only does being
overweight increase the risk of dying from viruses but it also increases the risk of heart disease. He should be
applauded for bringing this topic to light and the healthcare system should take notice of this important point of view.
The evidence clearly reveals dietary changes rapidly improve health markers of those most at risk of COVID-19. We must
help and empower people to make those changes as a matter of urgency’
Dr Campbell Murdoch, GP (Special Interest in Metabolic Health), NHS England Sustainable Improvement Team - Clinical
Adviser, Royal College of General Practitioners - Clinical Adviser and Entrepreneur said,
“Scientific literature regularly reports on hypertension, cardiovascular disease and diabetes as risk factors for worse
outcomes in COVID-19. The prevalence and seriousness of poor metabolic health in COVID-19 is an important public health
message. But this is not for scare mongering. Dietary change with reduction in ultra-processed foods, sugar and refined
carbohydrates can lead to a rapid improvement in metabolic health and weight loss. People need awareness, knowledge and
support to make choices that are best for their health. This article is important for raising awareness and knowledge.
We must all rise to the challenge to provide support to the nation, and take the necessary actions, to improve metabolic
health and reduce the lethality of COVID-19."
Dr JS Bamrah CBE, FRCPsych; Consultant Psychiatrist, GMMH; Hon Reader, University of Manchester and Chairman of British
Association of Physicians of Indian Origin said,
“COVID19 has brought the world to a standstill like no other phenomenon since WWII. And whilst much of the hype has been
about morbidity and mortality figures and managing the pandemic by social measures, it is an inescapable fact that some
individuals have been more susceptible to the disease than other because of their inherent risks from overt or covert
medical problems. It was not until Dr Aseem Malhotra, renowned cardiologist, drew my attention to risks from obesity and
diet related disease that I have become aware that this is a major predisposing factor in the majority of individuals,
especially those from BAME backgrounds struck by the virus. Let’s not wait till the next pandemic to implement his
advice. Let’s do it now.”Dale Pinnock BSc ( Hons), PgDip Nutritional Medicine, Nutritionist and Author said,
“The beauty of this is that making meaningful change to your diet is actually quite easy, and in many cases, can
actually save you money as well. Start to build your diet around lean proteins, healthy fats, plenty of fibre, and non
starchy vegetables. Think vegetable and goats cheese omelette for breakfast. A good dense salad with a few mixed beans,
a few nuts, maybe some cooked meats or tofu for lunch Chicken and vegetable curry with spiced greens or baked salmon and
roasted Brussels sprouts for dinners. Delicious food, easy to prepare, and in most cases far cheaper than many packaged
foods. When you eat like this you are creating meals that support so many aspects of metabolic health. They keep blood
sugar stable, reduce inflammatory load, cut out the array of pro-inflammatory fatty acids found in processed foods, and
have a far superior nutritional density. The other sad irony here is that in many of our supermarkets these foods, that
so effectively support our health, are there in abundance and even going to waste, as the nation stockpiles pasta.”Kimmy Pearson, Harley Street and BANT Registered Nutritionist said,
“Associations between our health status and the extent to which COVID-19 is likely to affect us are becoming
increasingly apparent. We are now well aware of the increased risk of death to those carrying excess weight. There has
been the tendency to tip toe around the issue of obesity, with clinicians hesitant to point it out to their patients for
fear of repercussion and accusations of 'fat shaming'. While this is without doubt a very sensitive subject which must
be handled with care, the current pandemic highlights thevery real fact that overlooking the seriousness of excess
weight is costing lives. BAME individuals are not only more likely to die from COVID-19, this darker-skinned demographic
are also known to be at higher risk of vitamin D deficiency, known to play an important role in immunity. The good news
is that with positive changes to our nutrition, improvements can come rapidly. On the right diet, body fat can reduce
quickly and healthily. Daily exercise, particularly in daylight and surrounded by nature, can have profound effects on
our mental wellbeing, as well as physical. Cultivating mindfulness through practices like meditation and conscious
eating can help us become aware of our non-hunger drivers foreating and implement strategies to fulfil those needs more
effectively. All of these practices not only have the potential to dramatically improve our physical and mental health,
they could mean the difference between life and death.”
NOTES FOR JOURNALISTS
Ultra-Processed are packaged food usually of five or more ingredients with additives and preservatives which are
energy-dense, high in unhealthy types of fat, refined starches, free sugars and salt, and poor sources of protein,
dietary fibre and micronutrients. Ultra-processed products are made to be hyper-palatable and attractive, with long
shelf-life, and able to be consumed anywhere, any time. Their formulation, presentation and marketing often promote
overconsumption. Studies based on the international NOVA classification show that ultra-processed products now dominate
the food supplies of various high-income countries and are increasingly pervasive in lower-middle- and
upper-middle-income countries. The evidence so far shows that displacement of minimally processed foods and freshly
prepared dishes and meals by ultra-processed products is associated with unhealthy dietary nutrient profiles and several
diet-related non-communicable diseases. Ultra-processed products are also troublesome from social, cultural, economic,
political and environmental points of view.
Good metabolic health is defined by having optimal levels of
Waist circumference ( <102/88 cm for men/women)
Blood pressure < 120mmHg systolic and diastolic < 80 mmHg
Haemaglobin A1C < 5.7%
Triglycerides < 1.7 mmol/L
HDL cholesterol > 1mmol/L And not being on any medication
Metabolic syndrome which is associated with the highest risk of health complications from COVID -19 is having three or
more of the above risk factors