Evidence is pouring in that people with adequate vitamin D status seem to be better protected against harmful effects of Covid-19.

This is not surprising; people who practice healthful lifestyles—eating well, being active, getting out in the fresh air, maintaining a healthy weight, not smoking, not drinking too much—generally survive this infection more easily.

Vitamin D, I must remind you, is not really a vitamin.  It is a hormone induced by the effects of sunlight on skin.

Sunlight is by far the most effective way to get it.   Foods provide much less.

As for supplements, it’s hard to say.  They are under investigation.

I’ve been collecting items:

• An account of a clinical trial in Italy published in Medium: “Among the 26 hospitalized people who received standard care alone, fully half went on to the intensive care unit (ICU) because their disease had worsened. Two of them died. But among the 50 people who received the vitamin D treatment on top of standard care, only one person ended up in the ICU. None died.”  The study itself concludes: “…administration of a high dose of Calcifediol or 25-hydroxyvitamin D…significantly reduced the need for ICU treatment of patients requiring hospitalization due to proven COVID-19. Calcifediol seems to be able to reduce severity of the disease, but larger trials with groups properly matched will be required to show a definitive answer.”
• Medium’s discussion of what is known about Vitamin D supplements and Covid-19: “If we ask the question “Does vitamin D prevent/treat COVID-19?” the only real answer is “How could you possibly know?””
• Consumer Reports on whether you should be taking vitamin D supplements: its not-particularly-helpful conclusion: “Ultimately, whether to get tested or take a supplement and how to do it comes down to having a discussion with your doctor.”

As always with supplements, a market is involved.  This one is not trivial, even in the UK.

• Vitamin market set to hit £500m but where are the new users?  Use of Vitamin D supplements is growing fast thanks largely to growing media attention during the pandemic but interest in nearly all other single vitamins has dropped, and there’s still a lack of new consumers entering the market, according to new data from Mintel…. Read more

An obesity newsletter I subscribe to—Obesity and Energetics Offerings—provides items suggesting that conflicts of interest may be involved.

• Vitamin D deficiency linked to 54% higher SARS-CoV-2 positivity rate: Study: “The associations between vitamin D status and COVID-19 risk continue to strengthen, with new data from Quest Diagnostics and Boston University indicating that people with deficiency in the sunshine vitamin may have a significantly higher positivity rate for SARS-CoV-2, the coronavirus that causes COVID-19.“
• The study in question, Evidence That Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, reports conflicted interests: “W.B.G receives funding from Bio-Tech Pharmacal, Inc. (Fayetteville, AR). H.L. sells vitamin D supplements. GrassrootsHealth works with various supplement suppliers to test the efficacy of their products in various custom projects. These suppliers may be listed as sponsors of GrassrootsHealth.”   Basically, it’s industry-funded.
• One letter in response to the study points out that “the efficacy of high-dose supplementation of vitamin D₃ in reducing risk of COVID-19 infection is mere extrapolation of currently available evidence, which is often conflicting, on the effectiveness of vitamin D3 in reducing risk of other respiratory tract infections.”
• To this, the authors have a lengthy rebuttal.

My bottom line at the moment: the science is still unfolding.  What to do while waiting for further research?  I like these Considerations for Obesity, Vitamin D, and Physical Activity Amid the COVID-19 Pandemic:

Until further breakthroughs emerge, we should remember that modifiable lifestyle factors such as diet and physical activity should not be marginalized. Decades of empirical evidence have supported both as key factors promoting health and wellness. In times of crisis, whether it be real or perceived, there is something to be said about the benefits of empowering people to actively preserve their own health.

Get outside, move around, expose some skin to sunlight.  Even in winter.

The potato industry has a problem.  Some nutrition experts do not recommend them and argue that potatoes—especially French fries—raise blood sugar levels and should be excluded from recommendations to increase vegetable intake (I love potatoes in any form but try not to overeat them—everything in moderation if you can manage that, and I can).

In any case, the The Alliance for Potato Research & Education (APRE) is devoted to protecting the reputation—and sales–of potatoes, and funds research for that purpose.

The study: Daily intake of non-fried potato does not affect markers of glycaemia and is associated with better diet quality compared with refined grains: a randomised,crossover study in healthy adults.   EA Johnston et al.  British Journal of Nutrition (2020), 123, 1032–1042.

Results: “Compared with refined grains, the HEI-2015 Healthy Eating Index] scores..were higher following the potato condition. Consuming non-fried potatoes resulted in higher diet quality, K  [potassium] and fibre intake, without adversely affecting cardiometabolic risk.”

Financial Support: The Alliance for Potato Research and Education provided funds for the research conducted. Their staff were not involved in any aspects of conducting the study, analyzing the data or interpreting the results presented.

Comment: The APRE says it remains firmly committed to the scientific integrity of industry-funded research”  Its guidelines for research integrity sound good, but don’t address the inherent problems of industry-funded research: the well established “funding effect” that virtually guarantees that industry-funded research will produce results that favor the sponsor’s interests, and the also well established observation that investigator bias tends to occur at an unconscious level.  The exclusion of fried potatoes from this particular study suggests that the investigators know that frequent eating of French fries is a marker of poor diet quality.  I think potatoes have a place in healthy diets and that much depends on their particular role and preparation.  As with much in nutrition, the potato situation is complicated, and industry funding does not help with clarification.

Michael F.  Jacobson.  Salt Wars: The Battle Over the Biggest Killer in the American Diet.  MIT Press, 2020.

Michael Jacobson was one of the founders of the Center for Science in the Public Interest, which he directed for more than 40 years.

His book comes with an introduction by Tom Frieden, former head of New York City’s Health Department and Director of the CDC.

I wrote a blurb for it:

Public health authorities advise eating less salt as a way to prevent high blood pressure, but a few scientists disagree. For anyone confused by these arguments, Salt Wars is a must read.  Michael Jacobson has been fighting these wars for decades, and his assessment of the research on both sides—and the policy implications–is exceptionally fair, balanced, and fascinating.

Here are a few excerpts:

• One reason that the debate has been so vigorous is that most journalists treat new reports supporting the conventional view on salt with a yawn.  Dog bites man?  Big deal.  What does capture the attention of journalists and headline writers are the man-bites-dog reports—those suggesting that eating less salt would be harmful—especially when they are conducted by credentialed researchers at prominent universities and published in respected journals…The poor consumer, lacking an advanced degree in epidemiology or nutrition, can get dizzy trying to follow the arcane biomedical and statistical jousting (p. xvi).
• I was sorely disappointed that the FDA was not setting mandatory maximum sodium levels.  Such limits for all foods in a category…have at least three advantages over a voluntary approach.  First, they would have teeth and ensure that all companies actually trimmed sodium in their saltiest products.  Second, the FDA could easily enforce them.  And third, they would provide a level playing field…I have since been persuaded that the voluntary approach was inevitable (p. 139).
• The process to propose sodium reductions was frustratingly slow, but there was no villain or cabal that sought to undermine the FDA’s effort to lower sodium consumption.  Rather, it was a case of how the Washington policy-making apparatus works when it comes to anything that is complicated, controversial, and consequential…It took the administration so long to propose the guidelines that there was no time to finalize them and the matter has languished for four years  (p. 143).

The USDA destroyed the ability of its Economic Research Service (ERS) to do investigations that might prove inconvenient for this administration (see my most recent post on this topic), but this agency is still producing reports on specific commodities.

Here are the latest dairy reports.  You have to be pretty nerdy to delve into these Excel spreadsheets but if you do, you will get a good idea of what ERS staff are doing these days as well as learn details about dairy production.  TMI?  Maybe.

Food Policy Action started keeping score on congressional votes on food issues in 2013, but the last time I wrote about its scorecard was in 2017.2020

It has just published its 2020 interactive Scorecard, which you can use to check how your state’s legislators score on food issues.

As Food Policy Action puts it, the “scorecard underscores Senate’s failure to feed hungry, protect workers.”

Food Policy Action identifies six ways Trump has hurt eaters, food workers and farmers.

The purpose of the Scorecard is to hold legislators accountable.  Now is the time to do that.

Vote with your votes by November 3.

I’m always interested to know how food and beverage companies spend money on candidates.  The Center for Responsive Politics’ Open Secrets database is the best source that I know of for this information, but it takes work to find what you are looking for.

Food Dive has a summary of donations from ten leading food and beverage companies.

Food Dive’s explanation for why donations have dropped since 2016, especially to Republican candidates?  The companies think it works better for them to stay out of today’s polarized politics.

Or maybe they think the Deomocrats will win this time?

Stevia Beverage Consumption prior to Lunch Reduces Appetite and Total Energy Intake without Affecting Glycemia or Attentional Bias to Food Cues: A Double-Blind Randomized Controlled Trial in Healthy Adults.  Nikoleta S Stamataki, Nikoleta S Stamataki, Corey Scott, Rebecca Elliott, Shane McKie, Douwina Bosscher, John T McLaughlin. The Journal of Nutrition, Volume 150, Issue 5, May 2020, Pages 1126–1134.

Method: This randomized, controlled, double-blind crossover study gave 20 healthy participants water or beverages with various sweeteners before lunch.  The investigators measured how much participants ate after consuming each drink.

Conclusion:  “This study found a beneficial and specific effect of a stevia beverage consumed prior to a meal on appetite and energy intake in healthy adults.”

Conflict of interest statement: “This study was supported by funding from the UK’s Biotechnology and Biological Sciences Research Council (BBSRC) through a BBSRC Case Studentship awarded to NSS. Cargill prepared and provided the test products free of charge.  Author disclosures: DB and CS were employed by Cargill during the preparation of this manuscript, and Cargill produces stevia. The other authors report no conflicts of interest.”

Comment:  The artificial sweetener Stevia is manufactured by Cargill.  Two of the authors work for Cargill.  Cargill has a vested interest in demonstrating that consumption of Stevia helps people lose weight.  Whether artificial sweeteners help with weight loss is a question much debated.  Industry-funded studies like his one tend to find benefits.  Some independently funded studies do too but others do not.

My guess: artificial sweeteners might help some people, but their overall benefits, if any, are small.

My take: one of my food rules is not to eat anything artificial, so Stevia is off my dietary radar from the get-go.

The Mexican state of Oaxaca became the first to ban the sales of junk foods to children under the age of 18.

The state of Tabasco did the same.

A dozen other Mexican states are considering similar actions.  The rationale is clear: the health consequences of obesity in general and with Covid-19 in particular.

One-third of Mexicans aged 6 to 19 are overweight or obese, according to UNICEF. They may not be disproportionately affected by COVID-19 now, but they can suffer myriad health issues, especially in adulthood.

And Mexico’s new warning labels are now in effect and will be required for all packaged foods by the end of the year.

Mexico has been able to implement these measures despite overwhelming food industry opposition.

How?  I credit the outstanding advocacy work of the Mexico’s National Institute of Public Health and the consumer coalition, Alianza por la Salud Alimentaria.