‘It is clear’ that the food industry must share the blame for the obesity pandemic, as well as for the severity of COVID-19 disease and its ‘devastating consequences’.
This is the position of three researchers in London, who penned an editorial in the British Medical Journal (BMJ) published yesterday (10 June 2020).
“The world is facing two pandemics. One immediately, COVID-19, and the other a longer-term crisis with obesity,” said study co-author and professor of global health research at the Wolfson Institute of Preventive Medicine, Feng He. “Clear evidence has emerged that the two pandemics interact.”
Linking obesity with COVID-19 severity and death
As the researchers point out, increasing evidence suggests that obesity is an independent risk factor for severe illness and death from SARS-CoV-2.
In the UK, the association appears significant: individuals who were overweight or obese made up 78% of the confirmed COVID-19 infections and 62% of COVID-19 deaths in hospitals.
Further, linking UK COVID-19 data to data from a population cohort and electronic health records, has revealed a dose-response relationship between excess weight and severity of the novel coronavirus.
This suggests that the more severe the obesity, the more likely the individual is to be hospitalised for – and/or potentially die from – SARS-CoV-2.
Similar findings have been confirmed in smaller studies in Europe, the US, and in the Asia-Pacific Region.
So why this relationship between obesity and COVID-19? The researchers suggest that several mechanisms could explain the link, including that obesity: leads to larger quantities of ACE2 in the body – the enzyme exploited by the virus for cell entry; diminishes the immune response; and reduces lung function.
Obesogenic environments: ‘It is difficult not to over-consume calories’
Unfortunately, the novel coronavirus outbreak is far from the only risk factor amplified by obesity, the researchers stress.
Obesity is a major cause of high blood pressure, type 2 diabetes, heart disease, stroke, and cancer.
Obesity: the facts
In 2016, more than 1.9 billion adults worldwide were overweight or obese.
In the US and UK, the prevalence of overweight and obese has reached 65%-70% in adults.
In 2014-15, the NHS spent more than £6bn (€6.7bn) on tackling the direct consequences of obesity.
For the editorial authors, Wolfson Institute of Preventive Medicine’s He, Queen Mary University of London’s Monique Tan, and Barts and The London Hospital’s Graham MacGregor, the obesity pandemic is inherently linked to the food industry.
“The obesity pandemic is the result of living in food environments where it is difficult not to over-consume calories,” they noted.
“The global food industry produces and extensively promotes cheap, sugar sweetened beverages and ultraprocessed foods high in salt, sugar, and saturated fat that provide only a transient sensation of fullness.”
Further, amid the pandemic, food poverty, supply chain disruptions, and panic buying increased, which may have limited access to fresh foods.
This, the researchers argued, tilted the balance towards a greater consumption of highly processed and long shelf-life foods – which are ‘usually high in salt, sugar, and saturated fat’.
A call for government action
To date, government have ‘done too little’, say the researchers, who are urging regulators to take action – and fast.
“Unlike most other risk factors identified for COVID-19 such as age, sex and ethnicity – obesity is a modifiable risk factor,” explained MacGregor, professor of cardiovascular medicine.
“This is why governments worldwide must seize the opportunity to help people to eat more healthily and enforce measures to restrict the promotion, marketing, and advertising of unhealthy foods and ensure their reformulation to contain far less salt, sugar, and saturate and fat. This would reduce mortality from this vicious virus and many other chronic diseases.”
This call to action is particularly pertinent, given the UK Government’s decision to halt measures designed to address unhealthy diets due to the COVID-19 outbreak.
Co-author and PhD researcher Tan stressed that obesity is the major cause of type 2 diabetes which, in itself, is another potentially modifiable risk factor for more severe COVID-19. “However, long planned and awaited governmental measures to address this have been put on hold due to the COVID-19 outbreak, at a time when they have never been more necessary.”
FDF finds blame ‘deeply offensive’
UK trade association Food Drink Federation (FDF) has spoken out against MacGregor’s implications concerning the food industry’s role in COVID-19 deaths.
“To blame the food industry for the COVID-19 mortality rate is deeply offensive,” said FDF’s chief operating officer Tim Rycroft.
Manufacturers are ‘fully engaged’ with a range of government-led initiatives designed to combat obesity, he continued, citing ‘substantial changes’ to date: “Compared to four years ago, FDF member shopping products contribute 11% less calories, 11% fewer sugars, and 14% less salt to the average shopping basket.”
The lobby group itself is advocating for a more holistic approach to the problem, including emphasis on positive nutrition. “We believe the Government should now invest money in specific measure that support those people and areas most affected by obesity,” said Rycroft.
“We believe a whole lifestyle approach will be most effective, focusing on how we achieve a balanced diet and keep active, and not any single nutrient.”