{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:50:24Z","timestamp":1790815824344,"version":"4.1.0"},"reference-count":54,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T00:00:00Z","timestamp":1675900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Diet, the most important modulator of inflammatory and immune responses, may affect COVID-19 incidence and disease severity. Data from 196,154 members of the UK biobank had at least one 24 h dietary recall. COVID-19 outcomes were based on PCR testing, hospital admissions, and death certificates. Adjusted Poisson regression analyses were performed to estimate the risk ratios (RR) and their 95% confidence intervals (CI) for dietary inflammatory index (DII)\/energy-adjusted DII (E-DII) scores. Models were adjusted for sociodemographic factors, comorbidities, smoking status, physical activity, and sleep duration. Between January 2020 and March 2021, there were 11,288 incident COVID-19 cases, 1270 COVID-19-related hospitalizations, and 315 COVID-19-related deaths. The fully adjusted model showed that participants in the highest (vs. lowest) DII\/E-DII quintile were at 10\u201317% increased risk of COVID-19 (DII: RR Q5 vs. Q1 = 1.10, 95% CI 1.04\u20131.17, Ptrend &lt; 0.001; E-DII: RR Q5 vs. Q1 = 1.17, 95% CI 1.10\u20131.24, Ptrend &lt; 0.001) and \u224840% higher risk was observed for disease severity (DII: RR Q5 vs. Q1 = 1.40, 95% CI 1.18\u20131.67, Ptrend &lt; 0.001; E-DII: RR Q5 vs. Q1 = 1.39, 95% CI 1.16\u20131.66, Ptrend &lt; 0.001). There was a 43% increased risk of COVID-19-related death in the highest DII quintile (RR Q5 vs. Q1 = 1.43, 95% CI 1.01\u20132.01, Ptrend = 0.04). About one-quarter of the observed positive associations between DII and COVID-19-related outcomes were mediated by body mass index (25.8% for incidence, 21.6% for severity, and 19.8% for death). Diet-associated inflammation increased the risk of COVID-19 infection, severe disease, and death.<\/jats:p>","DOI":"10.3390\/nu15040884","type":"journal-article","created":{"date-parts":[[2023,2,10]],"date-time":"2023-02-10T05:18:35Z","timestamp":1676006315000},"page":"884","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Diet-Related Inflammation Is Associated with Worse COVID-19 Outcomes in the UK Biobank Cohort"],"prefix":"10.3390","volume":"15","author":[{"given":"Longgang","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Wirth","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA"},{"name":"College of Nursing, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4384-4962","authenticated-orcid":false,"given":"Fanny","family":"Petermann-Rocha","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica, Facultad de Medicina, Universidad Diego Portales, Santiago 8370068, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Solange","family":"Parra-Soto","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK"},{"name":"Department of Nutrition and Public Health, Universidad del B\u00edo-B\u00edo, Chillan 3780000, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3406-3002","authenticated-orcid":false,"given":"John C.","family":"Mathers","sequence":"additional","affiliation":[{"name":"Human Nutrition & Exercise Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill P.","family":"Pell","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7190-9025","authenticated-orcid":false,"given":"Frederick K.","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Health and Wellbeing, University of Glasgow, Glasgow G12 8RZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2612-3917","authenticated-orcid":false,"given":"Carlos A.","family":"Celis-Morales","sequence":"additional","affiliation":[{"name":"School of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow G12 8TA, UK"},{"name":"Human Performance Lab, Education, Physical Activity and Health Research Unit, University Cat\u00f3lica del Maule, Talca 3466706, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0677-2672","authenticated-orcid":false,"given":"James R.","family":"H\u00e9bert","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Cancer Prevention and Control Program and Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC 29208, USA"},{"name":"Department of Nutrition, Connecting Health Innovations LLC, Columbia, SC 29201, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1016\/j.clnu.2020.03.022","article-title":"ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection","volume":"39","author":"Barazzoni","year":"2020","journal-title":"Clin. 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