Startling research has emerged which shows that being obese or even slightly overweight can worsen the effects of Covid-19.
Covid-19 poses a specific risk to people living with pre-existing conditions such as atherosclerosis, type 2 diabetes and hypertension. These conditions are also common in people with obesity. While initial data pointed towards the older population and those with these comorbidities being particularly vulnerable, an increasing number of reports have now also linked obesity to more severe Covid-19 illness and death.
The statistics
What has been termed ‘the elephant in the room’ when it comes to this pandemic, is the fact that overweight and obesity are already major global healthcare problems, now just making a really serious global health situation that much worse. In fact, data from the first 2 204 patients admitted to 286 National Health Service Intensive Care Units with Covid-19 in the United Kingdom revealed that 72,7 per cent of them were overweight or obese.
Research has found that patients with type 2 diabetes and metabolic syndrome might have to up 10 times greater risk of death when they contract Covid-19.
Metabolic syndrome is a cluster of conditions that occur together, increasing your risk of heart disease, stroke and type 2 diabetes. These conditions include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels.
Given the extremely high rates of overweight and obese people around the globe, a high percentage of the population who will contract coronavirus are expected to also have a BMI of over 25.
Lockdown weight up
To add fuel to a growing fire, for many people staying at home, consumption of more sugar and refined flour, along with less mobility and physical activity, have put even more people at an increased risk of metabolic disease. An additional health challenge during the coronavirus crisis seems to be the consumption of a varied, nutrient-rich diet and keeping calorie intake under control.
What’s more is that this current crisis and the need to stay home are prompting many people to rely on processed food with longer shelf life instead of fresh produce, and canned food which is generally higher in salt. We might well see an increase in weight if this persists for a longer period of time.
Cause for even more concern is that the resultant economic downturn caused by this pandemic might well worsen obesity, especially amongst the most vulnerable.
A local perspective
Dr Gary Hudson, a specialist physician practicing in Betty’s Bay in the Western Cape, with a special interest in weight management, said we are facing a pandemic on top of an obesity epidemic, and reiterates that there is a definite link between the more obese areas of the world and those that are being severely affected by this disease.
He added that Covid-19 is spreading amongst a global obese population that numbers 2,4 billion people, which means that more than 30 per cent of the world’s population is at risk of severe disease and even death.
“This is creating the perfect storm,” he said.
Hudson used France as an example, saying that the highest death rate due to Covid-19 in the country was in North-Eastern France, the same region with statistically the largest overweight and obese population.
In fact, BMI was found to be the most important independent risk factor, and a special guideline was introduced for anyone with a BMI of over 27,9 to be tested and isolated.
Similar patterns were found in Italy.
“Once again the map of severe disease and obesity completely overlaps,” he said. Conversely, Singapore and South Korea had comparatively low death rates but also have populations with a generally low BMI.
More about BMI
BMI is a simple calculation using a person’s height and weight, and is calculated as BMI = kg/m.
Although it is not the most accurate measurement, it is the widely accepted global definition of obesity – as per the World Health Organization – that defines a BMI of over 25 as overweight, and over 30 or more as obese.
“It is a very important clinical measurement,” Dr Hudson said, adding that even a BMI of over 25, which is literally just above the normal weight range, seemed to correlate with a higher incidence of serious disease, particularly when combined with a comorbidity such as hypertension.
He believes it is important to stress that the presence of abdominal fat is associated with a high risk of severe complications due to Covid-19. This is relevant for people with a mild increase in weight, and not only for the extremely obese.
Furthermore, in a French study, the risk for invasive mechanical ventilation in patients with Covid-19 infection admitted to Intensive Treatment Units was more than seven-fold higher for obese patients with a BMI over 35.
In South Africa, 70 per cent of women, 35 per cent of adult men and 13 per cent of children fall into the obese and overweight category. Only 30 per cent engage in regular formal physical activity, and 82 per cent consume high-calorie, low-nutritional and processed fast foods.
“Don’t wait. More than ever, it is important to lose weight,” Dr Hudson said.
Where to from here?
The bottom line is that lifestyle can have a major impact on a person’s immune system. The basic weapons against many diseases, and now also against serious Covid-19 illness are diet and exercise, weapons available to most of us but not nearly enough of us take advantage of them.
Now that there is a deeper understanding of the relationship between obesity and Covid-19, therapeutic interventions such as proven weight loss medication and low calorie diets might well be some of the tools that could potentially reduce the risk of developing severe Covid-19 illness as well as other lifestyle-related diseases.
More than ever before, eating real foods and exercising might help save lives. This pandemic has highlighted that more, not less, must be done to tackle and prevent obesity in our societies to prevent chronic disease, and decrease adverse reactions to these types of viral pandemics.
References:
• European Scientist – Covid-19 and The Elephant in the Room (April 2020) at https://www.europeanscientist.com/en/article-of-the-week/covid-19-and-the-elephant-in-the-room/ (website accessed on 17 June 2020)
• The New York Times – To Fight Covid-19, Don’t Neglect Immunity and Inflammation (May 2020) at https://www.nytimes.com/2020/05/25/well/live/to-fight-covid-19-dont-neglect-immunity-and-inflammation.html (website accessed on 17 June 2020)
• World Obesity – Coronavirus (Covid-19) & Obesity (2020) at https://www.worldobesity.org/news/statement-coronavirus-covid-19-obesity (website accessed on 17 June 2020)
• Chiappetta, S et al. COVID-19 International Journal of Obesity. Covid-19 and the role of chronic inflammation in patients with obesity. May 2020.
Sattar et al. Obesity – A Risk Factor for Severe Covid-19 Infection: Multiple Potential Mechanisms (Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre) 11 May 2020
• Mayo Clinic – Metabolic Syndrome (2019) at https://www.mayoclinic.org/diseases-conditions/metabolic-syndrome/symptoms-causes/syc-20351916(website accessed on 17 June 2020)
• Pandemic on Epidemic – Dr Gary Hudson June 2020
• Webinar by Dr Gary Hudson 4 June 2020
