A recent editorial in the journal Nutrients emphasizes how efficacious non-pharmacological interventions in conjunction with the promotion of healthy lifestyle and dietary patterns may improve overall health status and reduce the risk of infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as the potential adverse effects of coronavirus disease 2019 (COVID-19).
COVID-19 still affects our daily lives in 2022 and will continue to do so for the foreseeable future. Although advancements in science have focused on developing vaccines, producing/repurposing therapeutics, and promoting non-pharmacological interventions to lower disease burden, a fifth pandemic wave is now imminent in various parts of the world.
An undervalued mitigation strategy in preventing manifold adverse effects of COVID-19 is to actively promote healthy lifestyle patterns together with non-pharmacological interventions. This is becoming increasingly important in areas disadvantaged by their lack of access to vaccines.
Furthermore, lifestyle and dietary changes may offer additional protection and improve overall health. It is well known that inadequate nutritional status can be a serious risk factor for severe respiratory diseases and comorbidities (e.g., increased blood pressure, obesity, and diabetes), increasing the risk for severe disease and fatal outcomes in COVID-19 patients.
This is why MDPI’s journal Nutrients developed a special issue that aimed for research articles investigating nutritional status, lifestyle/dietary alterations, as well as the use of supplements concerning SARS-CoV-2 infection and COVID-19 outcomes.
In this editorial, Dr. Ronan Lordan from the Perelman School of Medicine, University of Pennsylvania, and Dr. William B. Grant from the Sunlight, Nutrition, and Health Research Center in San Francisco present these non-pharmacological advances in the battle against the COVID-19 pandemic.
The importance of vitamin D and zinc
Two studies were published in this special issue that supported the idea that vitamin D deficiency is pervasive among patients hospitalized for COVID-19 – one from the United Arab Emirates and the other one from Russia. Both studies emphasize that sufficient vitamin D levels may be clinically relevant, acting as a predictor of COVID-19 patient outcomes.
Another study from Saudi Arabia was a clinical trial that involved 69 SARS-CoV-2-positive patients that were hospitalized with mild to moderate COVID-19 in 2020 and showed that higher supplemental doses of vitamin D achieve much more favorable clinical benefits.
Moreover, patients infected with SARS-CoV-2 had substantially lower serum zinc concentrations than non-infected individuals; nonetheless, the difference between zinc concentrations for those with mild and those with moderate disease severity was not significant. Also, the use of high-dose zinc salts found significant improvements after only one day of treatment
Dietary supplements and nutraceuticals
In this Special Issue, two natural products known as Glycyrrhiza glabra extract and hesperidin may have a role in inhibiting viral entry via angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), which are two pivotal cellular proteins that SARS-CoV-2 uses to enter mammalian cells.
Furthermore, the author group from Poland has also reported that vitamin D was actually the most popular supplement during the second wave of the pandemic that started in September 2020; more specifically, vitamin D was taken by 23%, 38%, and 33% of study respondents during the first, second and third wave of the pandemic, respectively.
Other researchers that have contributed to this Special Issue had a much broader research interest in the potential nutritional requirements and supply chain issues that arose during the pandemic, highlighting programs in the United States distributing healthy meals and snacks.
Unintended consequences of COVID-19 response
Another salient research area tackled in this Special Issue was the unintended consequences of the COVID-19 response. One notable example is the study that showed weight gain among school teachers in Long Island (New York) who switched from in-person to online forms of teaching.
Emotional eating during the pandemic is also an issue, as demonstrated in Norway with a notable increase in high-sugar foods and beverage intake. The authors have also suggested the need for nutritional and psychosocial education and interventions during regular pregnancy monitoring.
In conclusion, additional broad-ranging research endeavors will be needed to fully grasp how the majority of the adverse effects of SARS-CoV-2 infection and COVID-19 could be prevented through diet, supplements and lifestyle changes.