COVID-19 and obesity: Nutrition community responds to PHE review

04 Jun 2020 --- A Public Health England (PHE) data review has established a significant relationship between weight-related comorbidities and COVID-19 mortality in the UK. The results highlight that among deaths with COVID-19 mentioned on death certificates, a higher percentage specifies diabetes, hypertensive diseases and chronic kidney disease than all-cause death certificates. UK-based Obesity Health Alliance (OHA)’s recent poll further highlights how consumers are increasingly calling for a nation-wide government battle plan to combat the UK’s “war on obesity.”

The PHE review reveals an evident relationship between body mass index (BMI) and death from COVID-19 in BMI over 30 kg/m2. Moreover, people with underlying health conditions or other recognized risk factors for severe outcomes from respiratory infections appear to be at a higher risk for poor outcomes from COVID-19 than people without these preconditions.

The review also points to the latest report from the Intensive Care National Audit and Research Centre (ICNARC), which indicates that 7.7 percent of patients critically ill in intensive care units (ICU) with confirmed COVID-19 were morbidly obese. This is compared with 2.9 percent of the general population (after adjusting for age and sex). 

The PHE review reveals an evident relationship between body mass index (BMI) and death from COVID-19 in BMI over 30 kg/m2.Another study using data from over 400,000 patients aged 40 to 69 from UK Biobank found that compared with non-overweight people (BMI less than 25 kg/m2), the odds ratios were 1.26 for those who were overweight, 1.37 for those in obese class I and 2.04 for those in obese classes II and III combined. The odds ratio divides the odds of a person having COVID-19 in a particular overweight or obese BMI group by the odds of a patient having COVID-19 in the control group, which refers to those people who were not overweight. 

This news is particularly concerning considering 28 percent of adults in England in 2018 were classified as obese (BMI of 30 kg/m2 or more) and 3 percent were morbidly obese (BMI of 40 kg/m2 or more), according to the Health Survey for England, as referenced in the PHE report. Notably, the review also highlights how the global pandemic has shed light on existing health inequalities depending on patients’ age, gender, socioeconomic background and ethnicity. 

“Urgent action” required – but how?
Commenting on the review, Professor Kamlesh Khunti of the University of Leicester notes a lack of recommendations on reducing the disparities identified in the review. Addressing this, the OHA has set forth a ten-step “urgent action” plan to reduce obesity. 

“We know that obesity also increases the risk of other diseases, including Type 2 diabetes and heart disease. It also has a wider negative impact on a person’s mental health and well-being. It’s never been more important for the government to take the steps that will help more people be a healthier weight to build our resilience to disease of all kinds, now and in the future,” Caroline Cerny, Alliance Lead of the OHA tells NutritionInsight. 

According to a OHA poll published this week, 74 percent of UK survey participants support a drive from the government to address obesity in the wake of emerging links with COVID-19. Likewise, 70 percent say this should now be more of a priority upon knowing about the potential link with COVID-19 complications. 

Last week, UK lobby group Action on Salt/Sugar (AoS) also proposed a ten-step plan of action to support and treat those living with obesity and related health conditions. Katharine Jenner, Campaign Director of AoS has expressed a similar concern that there has been “no action” taken to address the link between obesity and the evident increased risk of adverse outcomes from COVID-19. 

There is an element of personal responsibility in preventing obesity, but this can only be achieved with equitable access to healthy, affordable food, says Jenner of AoS.“Although there is an element of personal responsibility in both the treatment and prevention of obesity, this can only be achieved with equitable access to healthy, affordable food. This is far from a reality for millions of Britons. It is even more critical than ever for the food and drink industry, including the hospitality sector, to stop flooding us with unhealthy food options to keep us healthy,” Jenner maintains.

This aligns with the OHA’s poll results that revealed stark public support for policies that will help shape a healthier food environment. “Seventy-eight percent of people want manufacturers to reduce sugar from everyday foods, 74 percent are in favor of a 9 PM watershed on junk food adverts on TV and online and 72 percent support restrictions on unhealthy food promotions,” Cerny details.

Weight management innovation
While action groups call for legislation to protect the consumer, industry is coming up with its own solutions to tackle obesity, often driven by demands from health conscious consumers. 

“Naturally sourced, safe and efficacious weight management ingredients can help consumers manage their weight,” Miguel Martinho, Marketing Manager Europe, Kemin Human Nutrition and Health, tells NutritionInsight. This comes as the global pandemic has challenged healthy eating intentions and facilitated snacking and overeating. 

“In times when most of us are confined and are with limited access to physical exercise, satiety supplements can work as a complement in weight management strategies – always as part of a healthy and balanced diet alongside physical exercise,” he explains.

In this space, Kemin provides Slendesta, a hunger control ingredient specifically developed by the company to promote satiety. The potato protein-based facilitates portion size as well as snacking control, which in turn, helps consumers achieve weight management goals. 

Other recent weight management-facilitating ingredients from the industry include Pharmactive Biotech Products’ bioactive blend of carob bean extracts dubbed CSAT+ and BASF Human Nutrition’s newly launched brand of 2’-FL, called Prebilac. 

By Anni Schleicher, with additional reporting from Katherine Durrell