Covid-19: What we eat matters all the more now

Concern about a winter wave of covid-19 is rightly prompting calls for intense preparation. Measures to minimise community transmission and strengthen the test, trace, and isolate programme must start now, says the Academy of Medical Sciences, if we are to avoid double the number of hospital deaths seen in this first wave.1 The NHS also faces a huge workload in delayed treatment for people with cancer and support for people struggling with “long covid.”23 These mounting problems further justify calls for a rapid review of the UK’s preparedness.4

The government is waking up to the risks of a second wave and has reportedly responded with plans for a weight loss campaign.5 It’s doubtful that this could deliver results in time, but the move is welcome. With its links to diabetes, cardiovascular disease, cancer, and depression, obesity is a major cause of illness and death. It is also emerging, along with age and ethnicity, as a key risk factor for covid-19.

The good news is that medicine is finally embracing the view that weight loss and dietary change can reverse as well as prevent some of these obesity associated conditions. At the launch of The BMJ’s second collection on the science and politics of nutrition,6 the concept of diabetes reversal moved from the margins into the mainstream, and long term proponents of carbohydrate restriction for people with type 2 diabetes met trialists who have shown that energy restriction also works. (Recordings from the virtual sessions are at bmj.com/Food4Thought20.7) The potential for reduced drug treatments and improved wellbeing is vast.

So too is the potential of healthier eating for improved mental health. Diets that reduce inflammation and enhance the gut microbiome have been shown to improve mood, say Joseph Firth and colleagues.8

While acknowledging the many complexities and uncertainties, a consensus is emerging: we need diets richer in whole grains, fruit, vegetables, and legumes, with less red meat, refined carbohydrates, and highly processed foods. However, current global and national guidelines fall short in their impact on health as well as the environment, say Marco Springmann and colleagues.910

As also discussed in The BMJ collection, our food systems are making us ill.11 The covid-19 outbreaks at meat packing plants have focused minds on the meat industry as a driver for acute and chronic disease.12 Last month Monique Tan and colleagues wrote that the food industry should be held partly accountable “not only for the obesity pandemic but also for the severity of covid-19 disease and its devastating consequences.”13 The government must do more to hold the industry to account.

Improving what people eat has huge scope for improving physical and mental well being and taking pressure off health systems. Reducing the effects of a second wave of covid-19 is just the latest most urgent reason.