A healthy diet, rich in fruits and vegetables and low in sugar and calorie-dense processed foods, is essential to health. The ability to eat a healthy diet is largely determined by one’s access to affordable, healthy foods — a consequence of the conditions and environment in which one lives. In the United States, poor diet is the leading underlying cause of death, having surpassed tobacco use in related mortality.2 A study of dietary trends among U.S. adults between 1999 and 2012 showed overall improvement in the American diet, with the proportion of people who reported having a poor-quality diet decreasing from 55.9% to 45.6%; additional analyses, however, revealed persistent or worsening disparities in nutrition based on race or ethnicity, education, and income level.3
Global efforts to develop treatments for covid-19 have focused on drug repurposing, immunotherapies including convalescent plasma and monoclonal antibodies, and vaccines. Despite obesity prevalence rates of 40% in the United States, 29% in England, and 13% globally, to our knowledge none of the several thousand clinical studies of covid-19 in international clinical trial registries proactively recruit participants with obesity. On the contrary, several studies consider overweight or obesity as exclusion criteria. We call for proportional representation of people with obesity in clinical trials of drugs and vaccines, including dose finding studies.
More from The BMJ
Covid-19: What we eat matters all the more now
…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.
BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m2840
Lose weight. Make better food choices. Wear a mask.