Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort

Summary Background & aims A potential protection against COVID-19 infection by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of adequate nutrition on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-2-Cov infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort. Methods We assessed 9677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements separated 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS. Results Among 5194 non-HP participants, 122 reported to have received a diagnosis of COVID-19 based on a specific diagnostic test. Participants with intermediate adherence to the Mediterranean diet (MDS ≥4 & Conclusion In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals.