Closely following the Mediterranean Diet may help protect against COVID-19, but its benefits against symptoms or severity are unclear, Indonesian researchers report in PLOS One.
The systematic review, conducted in August 2023, identified six observational studies from five countries published from 2020 to 2023 that were based on food-frequency questionnaires. They had a total sample size of 55,489 patients.
The Mediterranean Diet, which mainly consists of plant-derived foods such as fruits, vegetables, legumes, nuts, and olive oil, is a rich source of antioxidants and is tied to a lower risk of infection and faster viral clearance, the authors said.
"Mediterranean Diet has been reported to possess immunomodulatory and anti-inflammatory properties," they wrote. "These properties are closely associated with the immunopathogenesis of COVID-19."
No link found with symptoms, severity
Four of the six studies identified a statistically significant correlation between closer adherence to the Mediterranean Diet and lower COVID-19 infection risk, while one study found a nonsignificant link.
One study reported a significant tie between better adherence to the diet and reduced COVID-19 symptoms, but three showed a nonsignificant association. While one study found that highly adherent participants were less likely to develop severe COVID-19, two others were inconclusive.
Overall, the analyses suggest higher Mediterranean diet adherence significantly reduced odds of COVID-19, with non-significant results against COVID-19 symptoms and severity.
One study concluded that dietary adherence significantly reduced the likelihood of all reported COVID-19 symptoms, with odds ratios (ORs) varying from 0.06 to 0.34 for each symptom. But three found a nonsignificant association (ORs, 0.84 to 0.992), and one analysis concluded that the link was nonsignificant.
One report found that participants with top-tertile dietary adherence were less likely to develop severe COVID-19 (OR, 0.23) than those in the bottom tertile. Two studies reported a nonsignificant link (ORs, 0.22 to 0.89).
Of two studies that analyzed the effects of individual dietary components against disease severity, one found no significant link, while another reported that consumption of more vegetables, fruits, legumes, nuts, whole grains, and fish were protective.
"Overall, the analyses suggest higher Mediterranean diet adherence significantly reduced odds of COVID-19, with non-significant results against COVID-19 symptoms and severity," the researchers wrote.