There is “increasing evidence” showing a link between obesity and the severity of illnesses from Covid-19 – and deaths, new research published in the UK has claimed.

Researchers at Queen Mary University of London have made the links and are calling on the UK government to “force” food manufacturers to remove “unnecessary” amounts of sugar, saturated fat and salt.

In an editorial published in the British Medical Journal today (10 June) entitled ‘Obesity and Covid-19: the role of the food industry’, the researchers said: “Increasing evidence is now demonstrating that obesity is an independent (and modifiable) risk factor for more severe illness and death from Covid-19.”

They suggest the food industry should “share the blame not only for the obesity pandemic, but also for the severity of Covid-19 disease and the devastating consequences of the Covid-19 outbreak”. 

The research found individuals in the UK who are overweight or obese made up 78% of confirmed Covid-19 infections and 62% of the deaths from the virus in hospitals.

“The more severe the obesity, the more likely the individual is to be hospitalised for Covid-19 and/or die from it,” they said.

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Adjusting for so-called “potential confounding factors” such as age, sex, ethnicity, and social deprivation, the risk of “critical illness” from the virus increased by 44% for people who are overweight, and almost doubled for those who are obese. And the risk of death from the disease “increased with the severity of obesity, with more than twice the risk in the most obese category”. 

Similar but smaller studies in the Asia Pacific, Europe, and the US revealed the same findings, the researchers claimed.

An executive at The Food and Drink Federation (FDF), which represents food and soft-drink manufacturers operating in the UK, said it found the implication the food industry is connected with the Covid-19 mortality rate “deeply offensive”. The trade body is encouraging the government to promote a change in lifestyles to combat obesity, the executive added.

The research results have been released ahead of a government review by Public Health England (PHE) looking at how ethnicity, gender and obesity impacts people’s health relative to Covid-19, which has delayed the publication of the report due by the end of May.

Almost two weeks ago, UK campaign group Action on Sugar and Action on Salt said it had provided an “evidence-based plan” for UK Prime Minister Boris Johnson to give support to those living with obesity and to improve people’s health over the longer term. 

It outlined a number of measures the UK government should take: ensure only healthy products are advertised and promoted; adopt fiscal measures to promote healthy food; make nutrition labelling mandatory; improve the nutritional profile of processed food and drink; and to set up an independent and transparent watchdog.

Graham MacGregor, the chairman of Action on Sugar and Action on Salt and a co-author of the study said: “Unlike most other risk factors identified for Covid-19 such as age, sex and ethnicity – obesity is a modifiable risk factor. This is why governments worldwide must seize the opportunity to help people to eat more healthily and enforce measures to restrict the promotion, marketing, and advertising of unhealthy foods and ensure their reformulation to contain far less salt, sugar, and saturated fat. This would reduce mortality from this vicious virus and many other chronic diseases.”

Tim Rycroft, the FDF’s chief operating officer, defended the industry’s role, particularly as employees in the sector have worked hard to keep people fed during the pandemic.

“Food and drink manufacturers are fully engaged with a wide range of government-led initiatives designed to tackle the huge public health challenge of obesity,” Rycroft said in a statement. “FDF members’ voluntary work is already delivering substantial changes. Compared to four years ago, FDF member products contribute 11% less calories, 11% fewer sugars, and 14% less salt to the average shopping basket. We believe the Government should now invest money in specific measures that support those people and areas most affected by obesity.”

Today’s report lists three mechanisms that could explain the relationship between Covid-19 and people’s weight: larger quantities of the ACE2 enzyme that the virus exploits to gain entry to cells; a diminished immune response; and reduced lung function.

“Paradoxically, it is now imperative for Governments and the food industry to take maximum action to get people to eat more healthily to reduce further deaths from Covid-19,” according to the authors of the report. 

Monique Tan, another co-author and PhD researcher at Queen Mary University of London, added: “Obesity is the major cause of type-2 diabetes which, in itself, is another potentially modifiable risk factor for more severe Covid-19. However, long planned and awaited governmental measures to address this have been put on hold due to the Covid-19 outbreak, at a time when they have never been more necessary. We urge the UK government to implement Action on Sugar’s evidence-based plan (presented to the Prime Minister two weeks ago).”