Following a report by PHE which reviewed how different factors such as obesity have affected COVID-19 risk and outcomes – Nutritionist Zoe Davies from Action on Sugar and Action on Salt shares insights into their new evidence-based plan
Obesity is not a new topic of discussion – with one in three adults in England having obesity1. However, during the COVID-19 pandemic, it has formed part of a different discussion on what factors put an individuals’ health most at risk from the impact of this virus. Furthermore, the Prime Minister has been rumoured to have shown a new interest in reducing obesity and improving public health after he experienced COVID-19 first hand.
COVID-19 and Obesity
There is increasing evidence demonstrating that obesity is an independent risk factor for more severe illness and death from COVID-19 – with 78% of those infected and 62% of hospital deaths caused by the virus being in individuals with overweight or obesity2-10.
Linking UK COVID-19 data to that of a population cohort (428,225 participants, 340 confirmed COVID-19 hospital cases) and to electronic health records (17,425,445 participants, 5683 COVID-19 deaths) demonstrates that the more severe the obesity, the more likely an individual will be hospitalised for COVID-19 and/or die from it 2,3.
Other risk factors include: age, ethnicity, deprivation, and underlying conditions, such as heart or kidney disease, and type 1 and type 2 diabetes. Obesity is the major risk factor that can potentially be modified meaning millions of people are living with an increased, but preventable, risk from worse outcomes from COVID-19.
Treating and Preventing Obesity
Whilst there is an element of personal responsibility, preventing and reducing obesity can only be achieved if there is equitable access to healthy, affordable food in an environment that supports everyone. This is why Action on Sugar and Action on Salt’s evidenced-based plan to reduce obesity and improve health for all describes measures to both treat and prevent obesity11.
Pre-COVID-19, the government had made commitments to reduce childhood obesity via two chapters of their Childhood Obesity Plan and the Prevention Green Paper. Some measures had been consulted on but despite some closing in 2018, we are yet to hear the outcome or any plans for implementation12-14.
In 2019, the former Chief Medical Officer published an independent report: Time to Solve Childhood Obesity, which included key recommendations to improve our food system. However, we have seen little action15.
The measures in the proposed Plan build upon these existing recommendations. As the outbreak of COVID-19 was developing and reached its peak, the government paused its work on obesity prevention. However, COVID-19 has shown that now, more than ever, measures to reduce and prevent ill health are imperative.
More research is needed to see how quickly the impact of improving health through a healthier diet, weight loss, and exercise would have on how COVID-19 would affect an individual. However, it is well established that even small lifestyle changes can have numerous benefits on overall health.
The food industry plays a vital role in shaping the environment. Industry lobbying and other influences are delaying key measures that would improve the health of the nation. The recommendations in the proposed plan include fiscal measures, advertising restrictions and mandatory labelling. However, to have the most impact, a new, independent and transparent food watchdog needs to be set up immediately to ensure clear, independent and evidence-based information is widely available and free from ministerial, industry and other vested-interested influences.
This is a major opportunity for both the government and the food and drinks industry to improve health for all and we urge ministers to follow through on their promises outlined in previous obesity plans whilst building on the success of other measures such as the Soft Drinks Industry Levy.
- NHS Health survey for England 2017 https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2017
- Ho FK, Celis-Morales CA, Gray SR, et al. Modifiable and non-modifiable risk factors for COVID-19: results from UK Biobank. medRxiv 2020. [Epub ahead of print]
- The OpenSAFELY Collaborative, Williamson E, Walker AJ, et al. OpenSAFELY: factors associated with COVID-19- related hospital death in the linked electronic health records of 17 million adult NHS patients. medRxiv 2020. [Epub ahead of print]
- Simonnet A, Chetboun M, Poissy J, et al. High prevalence of obesity in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) requiring invasive mechanical ventilation. Obesity (Silver Spring, Md) 2020. [Epub ahead of print]
- Lighter J, Phillips M, Hochman S, et al. Obesity in patients younger than 60 years is a risk factor for Covid-19 hospital admission. Clin Infect Dis 2020. [Epub ahead of print]
- Yu T, Cai S, Zheng Z, et al. Association Between Clinical Manifestations and Prognosis in Patients with COVID-19. Clin Ther 2020. [Epub ahead of print]
- Kalligeros M, Shehadeh F, Mylona EK, et al. Association of Obesity with Disease Severity among Patients with COVID-19. Obesity (Silver Spring, Md) 2020. [Epub ahead of print]
- Petrilli CM, Jones SA, Yang J, et al. Factors associated with hospitalization and critical illness among 4,103 patients with COVID-19 disease in New York City. medRxiv 2020. [Epub ahead of print]
- Ong SWX, Young BE, Leo YS, Lye DC. Association of higher body mass index (BMI) with severe coronavirus disease 2019 (COVID-19) in younger patients. Clin Infect Dis 2020. [Epub ahead of print]
- Huang R, Zhu L, Xue L, et al. Clinical findings of patients with coronavirus disease 2019 in Jiangsu province, China: A retrospective, multi-center study. PLoS Negl Trop Dis 2020; 14: e0008280.
- Obesity: Treat and Prevent. An evidenced-based action plan to reduce death from COVID-19 http://www.actiononsalt.org.uk/media/actiononsugar/Action-on-Sugar_Action-on-Salt_Treat-and-Prevent-Report-29th-May-2020..pdf
- Childhood obesity – a plan for action https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action
- Childhood obesity – a plan for action chapter 2 https://www.gov.uk/government/publications/childhood-obesity-a-plan-for-action-chapter-2
- Advancing our health: prevention in the 2020s – consultation document https://www.gov.uk/government/consultations/advancing-our-health-prevention-in-the-2020s/advancing-our-health-prevention-in-the-2020s-consultation-document
- Time to solve obesity: CMO special report https://www.gov.uk/government/publications/time-to-solve-childhood-obesity-cmo-special-repor
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