People who were overweight or obese made up 78% of confirmed COVID-19 infections – prompting calls for the food industry to ‘share blame’.
Published in the BMJ, the research cites evidence that obesity is an independent risk factor for more severe cases and death as a result of coronavirus.
In the UK, 62% of those with the virus who died in hospital were overweight or obese.
As a result, the authors are urging government to force the food and drink industry to take action. This includes reducing sugar, saturated fat and salt levels in their products, with an emphasis on promoting healthy foods.
Increased risk
The data has revealed a dose-response relationship between excess weight and the severity of COVID-19. In other words, the more extreme the obesity, the more likely the individual will be hospitalised for COVID-19 – and the higher the risk of death.
The risk of critical illness from COVID-19 rose 44% for those who were overweight. It almost doubled for those who were obese.
Additionally, the risk of death as a result of COVID-19 increased with the severity of obesity. Those in the most obese category had almost twice the risk of dying.
These conclusions were drawn after adjusting for possible confounding factors – including age, sex, ethnicity and social deprivation.
‘Unlike most other risk factors identified for COVID-19 such as age, sex and ethnicity – obesity is a modifiable risk factor,’ said Graham MacGregor, the co-author of the study and Professor of Cardiovascular Medicine at Barts and The London Hospital.
‘This is why governments worldwide must seize the opportunity to help people to eat more healthily. They must enforce measures to restrict the promotion, marketing, and advertising of unhealthy foods.
This will help to ensure their reformulation to contain far less salt, sugar, and saturated fat. It would also reduce mortality from this vicious virus and many other chronic diseases.’
Calls for government action
There are a number of mechanisms that could help to explain the link between obesity and the virus. Obesity leads to larger quantities of ACE2 in the body – the enzyme exploited by the virus for cell entry.
It also weakens the immune response and reduces lung function.
Monique Tan, co-author of the study and PhD researcher at Queen Mary University of London added: ‘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. But this is a time when they have never been more necessary.
‘We urge the UK government to implement Action on Sugar’s evidence-based plan that was presented to the Prime Minister two weeks ago.’
Findings were drawn from both a population cohort study (428.225 participants, 340 admitted with confirmed case) and another using electronic health records (17,425,445 participants, 5,683 COVID-19 deaths).
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