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Strict adherence to a Mediterranean diet may help prevent COVID-19, but its effect on symptoms and severity is unclear, Indonesian researchers report. PLOS One.

of Systematic reviewThe study, conducted in August 2023, identified six observational studies based on food frequency questionnaires published in five countries between 2020 and 2023. The total sample size was 55,489 people.

The Mediterranean diet, which is dominated by plant-based foods such as fruits, vegetables, legumes, nuts and olive oil, is rich in antioxidants and may lead to a lower risk of infection and faster clearance of viruses, the authors say.

“The Mediterranean diet has been reported to have immunomodulatory and anti-inflammatory properties,” the researchers wrote. “These properties are closely related to the immunopathology of COVID-19.”

No association was found with symptoms or severity.

Four of the six studies found a statistically significant correlation between adherence to a Mediterranean diet and a reduced risk of COVID-19 infection, while one study found no significant association.

One study reported a significant association between higher dietary adherence and reduced COVID-19 symptoms, while three studies showed no significant association.One study found that participants with higher dietary adherence were less likely to develop severe COVID-19, while two other studies were inconclusive.

Overall, the analysis suggests that greater adherence to the Mediterranean diet was associated with significantly reduced odds of COVID-19, but the results for COVID-19 symptoms and severity were not significant.

One study concluded that adherence to the diet significantly reduced the likelihood of all reported COVID-19 symptoms, with odds ratios (ORs) ranging from 0.06 to 0.34 per symptom, but three studies found no significant associations (OR, 0.84 to 0.992), and one analysis concluded the association was not significant.

One report found that participants in the top third of dietary adherence were less likely to develop severe COVID-19 than those in the bottom third (OR, 0.23); two studies reported nonsignificant associations (OR, 0.22-0.89).

Of two studies that analyzed the effect of individual dietary components on disease severity, one found no significant association, while the other reported a protective effect of high intakes of vegetables, fruits, legumes, nuts, whole grains, and fish.

“Overall, the analysis suggests that greater adherence to the Mediterranean diet was associated with a significantly reduced odds of developing COVID-19, although the results for COVID-19 symptoms and severity were not significant,” the researchers wrote.

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