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I was struck by headlines last week stating that a CDC study found that 78% of people hospitalized with Covid-19 were overweight or obese.

78%?  That is an enormous percentage.

I looked up the study: Body “Mass Index and Risk for COVID-19–Related Hospitalization, Intensive Care Unit Admission, Invasive Mechanical Ventilation, and Death — United States, March–December 2020.”

Summary

What is already known about this topic?

Obesity increases the risk for severe COVID-19–associated illness.

What is added by this report?

Among 148,494 U.S. adults with COVID-19, a nonlinear relationship was found between body mass index (BMI) and COVID-19 severity, with lowest risks at BMIs near the threshold between healthy weight and overweight in most instances, then increasing with higher BMI. Overweight and obesity were risk factors for invasive mechanical ventilation. Obesity was a risk factor for hospitalization and death, particularly among adults aged <65 years.

What are the implications for public health practice?

These findings highlight clinical and public health implications of higher BMIs, including the need for intensive management of COVID-19–associated illness, continued vaccine prioritization and masking, and policies to support healthy behaviors.

The data supporting the headline are found in Table 1 in the paper.  This shows that overweight and obesity do indeed account for 78% of hospitalizations, but also close to that percentage for ICU visits and mechanical ventilation, but “only” 73% of deaths.

Overweight and obesity were especially risky for people under age 65, although they caused plenty of problems for people over age 65 too.

Why do they make Covid-19 worse?  The best guesses have to do with inflammation and mechanical pressure on lungs.

I found these figures shockingly high.

Shouldn’t we be doing all we can to reduce the risks for overweight and obesity?  Yes we should.

And what are those risks?

• Poverty
• Racial discrimination
• Inadequate schools
• Unemployment
• Lack of adequate health care
• Air pollution
• And, of course, poor diets

If Covid-19 has taught us anything, it is that to prevent its bad effects, we need vaccinations and masking for sure, but we also need to change society.

I can’t believe we are even talking about this, but the FDA, USDA, and CDC have just issued a rare joint statement addressing it [my emphases throughout].

After more than a year since the coronavirus disease 2019 (COVID-19) outbreak was declared a global health emergency, the U.S. Department of Agriculture, the U.S. Food and Drug Administration and the U.S. Centers for Disease Control and Prevention continue to underscore that there is no credible evidence of food or food packaging associated with or as a likely source of viral transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19.

This, no doubt, is in response to statements from the World Health Organization team that visited Wuhan to determine the source of the virus causing Covid-19.  This team has not yet issued its report, but members of the team have talked to reporters.

Nature, for example, reports:

The researchers largely discounted the controversial theory that the virus accidentally leaked from a laboratory, and suggested that SARS-CoV-2 probably first passed to people from an animal — already a leading hypothesis among researchers. But the team also offered two hypotheses promoted by the Chinese government and media: that the virus, or its most recent ancestor, might have come from an animal outside China, and that once it was circulating in people, it could have spread on frozen wildlife and other cold packaged goods….Dominic Dwyer, a medical virologist at New South Wales Health Pathology in Sydney, Australia, and a member of the WHO team, says there is some evidence that the coronavirus could have spread on contaminated fish and meat at Chinese markets, and more details will be included in the written report.

According to the Wall Street Journal,

Beijing has blamed frozen-food imports as one cause of a string of recent outbreaks, and it has introduced mandatory testing and disinfection of foreign goods, saying it found traces of the virus on packaging of products including American pork, Saudi shrimp and Brazilian beef.

This idea has had a profound effect on sales of frozen foods.

Everyone seems to agree that there are four key hypotheses to explain the origin of this particular Coronavirus: 

• Direct animal vector
• Intermediary animal vector
• Laboratory accident
• Frozen food products,

The team could not identify a specific animal vector, dismissed the idea of a laboratory accident, but left open the possibility of frozen food.

The frozen food idea was suggested by the Chinese.

Several top Chinese scientists have further suggested that the Sars-CoV-2 virus that causes the Covid-19 disease may have arrived in the Huanan Seafood Wholesale Market in Wuhan city, the location of the world‘s first known outbreak, via frozen food imports, or what’s referred to as cold-chain transmission.

The WHO team’s report is considered a public relations win for the Chinese.

The W.H.O. team opened the door to a theory embraced by Chinese officials, saying it was possible the virus might have spread to humans through shipments of frozen food, an idea that has gained little traction with scientists outside China.… The virus was circulating in Wuhan several weeks before it appeared at the Huanan Seafood Wholesale Market, where some of the earliest clusters were initially reported, the experts said. It most likely emerged in bats and spread to humans through another small mammal, though the experts said they have not been able to identify the species.

The team, as I mentioned, considered a laboratory origin unlikely.

The team called for further investigation into the possibility of “cold chain” transmission, referring to the transport and trade of frozen food.

US Federal agencies don’t believe this for a minute; hence, their joint statement.

So if frozen foods are not at fault, and no animal vector can be conclusively identified, that leaves us with the dismissed-out-of-hand laboratory origin.

So what’s up with that?  Wuhan, where the pandemic started, happens to be the site of a laboratory that works on Coronaviruses.  

• New York Magazine has a long investigative report on this topic.
• Independent Science News has published several articles examining this possibility (the latest is here).
• US Right to Know has a reading list on Covid-19 origins

Why does the origin of the pandemic matter?  

• If we don’t know how this one happened, how can we take steps to prevent the next one?
• And it matters a lot to the makers of frozen foods.

Vitamin D is such a hot topic for its purported role in preventing or treating coronavirus infections that I seem to have written about it four previous times.  These are here, here, here, and here.

Now, a group of 120 scientists has called on world governments to get their populations to increases vitamin D consumption to 2000 to 4000 units per day, five to ten times higher than current recommendations.  Their letter is here.

This is especially interesting because nutrition and health societies in the UK  advise quite the opposite: no change in the usual recommendation for vitamin D intake (400 units/day).  Their report says (my emphasis):

• Do not offer a vitamin D supplement to people solely to prevent COVID-19, except as part of a clinical trial.
• Do not offer a vitamin D supplement to people solely to treat COVID-19, except as part of a clinical trial.

I’m always interested to see what ConscienHealth has to say about such things.

The passion of the vitamin D fan club is striking. However, neither passion nor speculation should be a substitute for facts. Right now, the facts tell us that the reason to take a vitamin D supplement is to protect our muscles and bones. Any thought that it will help with COVID-19 is speculation, and taking too much would be quite unwise.

My sentiments precisely.

Why, you must be asking, am I even asking a question like this?

Because of this study, obviously, which I somehow missed when it came out in August (thanks to toxicologist Marc Stifelman for sending it to me).

The study: Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID‐19.  Bousquet U, et al.  Allergy.  2020 Aug 6;10.1111/all.14549. Online ahead of print.

The hypothesis:

CAUTION:  Correlation does not necessarily mean causation.  The diets—and other lifestyle characteristics—of people in Romania and Latvia differ from those in the UK and Italy in other ways besides diet; other differences might well account for these variations.

Personally, I love cabbage in any form.

But for prevention of bad outcomes from Covid-19, I’m counting on vaccination, not kimchi or sauerkraut.

A scientific report in Proceedings of the National Academies titled Livestock plants and COVID-19 transmission,” demonstrates the impact of Covid-19 on workers in meat and poultry processing plants.

Our study suggests that, among essential industries, livestock processing poses a particular public health risk extending far beyond meatpacking companies and their employees. We estimate livestock plants to be associated with 236,000 to 310,000 COVID-19 cases (6 to 8% of total) and 4,300 to 5,200 deaths (3 to 4% of total) as of July 21….This study shows that meat and poultry slaughter plants were in fact vectors of the disease…Researchers found that poultry plants showed a significant relationship with COVID-19 cases, with pork plants showing the strongest relationship. Beef plants showed the strongest relationship with deaths from the illness.

The USDA has done its own analysis: “The share of all COVID-19 cases in nonmetro [rural] areas has been growing since late March, increasing from 3.6 percent on April 1 to 15.6 percent on December 7.”

Among nonmetro counties, the highest COVID-19 case rates are found in farming-dependent and manufacturing-dependent counties. The high prevalence of COVID-19 in manufacturing-dependent counties is due partly to higher COVID-19 case rates in meatpacking-dependent counties (those in which 20 percent or more of employment is in the meatpacking industry), almost all of which are manufacturing-dependent counties.

But another USDA report, specifically about the meatpacking industry, looks to me as though it is hiding what is happening in those plants.  It includes a chart indicating no special increase in cases among meatpacking workers.  No surprise, if meatpacking plants are epicenters that spread the infection to the local community (but the report doesn’t say that).

What it does say is this:

The two-week moving average number of new daily cases rose in meatpacking-dependent counties through the remainder of April, reaching a peak of nearly 50 cases per 100,000 by the end of the month. This two-week moving average was more than 10 times the prevalence seen in other rural counties. Even though cases in meatpacking-dependent counties started to decline in the month of May, they remained significantly higher compared to other rural counties, falling to just under seven times the number of average daily cases by the end of May.​…Even though meatpacking-dependent counties are dealing with a second wave, the surge in rural new cases does not appear to be driven by new outbreaks in the meatpacking industry. Meatpacking-dependent counties have maintained an almost identical pattern to other rural counties for a fifth straight month.

Confused?  Me too.  This looks like a whitewash.

Is this one result of the USDA’s moving the Economic Research Service out of Washington DC to Kansas City, a move clearly meant to—successfully—decimate the agency?

Politico asks: can the ERS move be reversed?  Not easily, alas.

It’s a good thing independent scientists and investigators are keeping an eye on this situation.

Leah Douglas of the Food and Environment Reporting Network (FERN) deserves much praise for tracking infections and deaths among farm and meatpacking workers.

Food Safety News reports that the European Commission is getting increasingly upset about fraudulent claims that specific food and supplement products will boost immunity and help protect against Covid-19 or even cure it.

Alas, they will not.

The EC is worried about online advertisements.  Food Safety News reported more than 350 cases of such claims in June.  Now there are even more.

In the US, we mostly see this sort of thing—websites from the supplement industry telling you to take supplements.  Here  is what this one claims, with my comments in red.

Supplements can help you address nutrient insufficiencies or deficiencies in your diet—but can they help you fight COVID-19? Not as far as anyone knows.

While there hasn’t been specifically-targeted research to determine which—if any—nutrients should be FDA-approved to ward off the virus, [Indeed] supplements are an ideal way to keep your body and your immune system functioning at optimal levels. No, they are not.  Food works much better.

As a result, many physicians and other health and wellness experts recommend beginning a simple supplement routine to ensure your body has the nutrients it needs to stay healthy.  Many others do not, and neither do I.…The supplements you take during the COVID-19 pandemic may not be specifically developed to ward off the coronavirus. Right.  So don’t expect them to work.

Still, research has shown that they all play an important role in boosting the immune system, preventing respiratory damage, strengthening the body against viral infections, reducing inflammation—or all of the above.  This is true, but largely in experimental studies likely to have been funded by the supplement industry.

Obviously, I am not a fan of supplements.  There just isn’t much evidence that they do anything useful for healthy people, and healthy people are the ones most likely to be taking them.

With respect to Covid-19, the best preventive strategy is avoidance (masks, distancing, etc).

The best immune-boosting strategy is to eat a healthy diet–largely (but not necessarily exclusively) plant-based, balanced in calories, and with minimal amounts of ultra-processed junk foods.

And let’s all hope the vaccination comes soon and works like a charm.

Happy holidays.

A few more items about what soft drink companies are up to these days.

1.  Pepsi is releasing spa kits to ease your home-bound stress (this one was sent to me by Nancy Fink, who is keeping track of this sort of thing for the Center for Science in the Public Interest).

The kits include an exfoliating cola-scented Pepsi sugar scrub, a Pepsi Blue face mask and a Pepsi cola-scented bath bomb, according to the company’s email. With its latest branded merchandise, Pepsi can tap into trends around self-care that have emerged during a chaotic year.

What do you have to do to get one?  You have to help market Pepsi, of course

The company launched a sweepstakes on Wednesday to let consumers enter for a chance to win a limited edition Pepsi Spa Kit. To participate, consumers must tweet #PepsiSpa and #Sweepstakes and tag one of their friends, the company said.

2.  Coca-Cola sought to shift blame for obesity by funding public health conferences, study reports

The Coca-Cola Company worked with its sponsored researchers on topics to present at major international public health conferences in order to shift blame for rising obesity and diet related diseases away from its products onto physical activity and individual choice, according to a new report.

Academics in Australia and the US worked with US Right to Know, which lobbies for transparency in the food industry, to obtain and analyse emails between Coke and public health figures about events run by the International Society for Physical Activity and Health (ISPAH).

They analysed 36 931 pages of documents to identify exchanges referencing Coke’s sponsorship of the International Congresses on Physical Activity and Public Health (ICPAPH) held in Sydney in 2012 and Rio de Janeiro in 2014 [The study is here].

3.  Coke and Pepsi join Nestlé (no relation) as “Plastic Polluters of the Year“

This is the third year in a row they have won this title from Break Free From Plastic. which demands corporate accountability for plastic pollution.  It’s always good to keep this in mind, along with soda companies opposition to bottle recycling laws.

I am indebted to BeverageDaily.com, for this item(and to Lisa Young for sending it to me).

Coca-Cola says:

In a year defined by a global pandemic, Coca-Cola’s Share a Coke campaign is dedicated to ‘holiday heroes’ – those who have gone the extra mile by dedicating time, energy and attention to their friends, families and communities…For 100 years, Coca-Cola has been known for bringing magic and cheer to the Christmas holiday…Now, alongside its iconic Santa and polar bears, Coca-Cola is celebrating the season by putting the spotlight on everyday heroes. Coca-Cola wants to help people feel connected, and to celebrate friends, family and people in the community who deserve an extra special gift of things, especially in an unprecedented year.

This, recall, is about marketing a sugary beverage strongly associated with poor diets, obesity, type-2 diabetes, and heart disease, all well established as risk factor for poor outcomes of Covid-19.

Here’s what MarketingDive says the campaign is about.

Comment: Educators, doctors, and caregivers ought to be advising everyone they deal with to do what they can to consume sugary beverages infreuently, and in extremely small amounts, if at all.   And that’s good advice for everyone in this holiday seaseon.