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Obesity, Hypovitaminosis D, and COVID-19 – April 2022

Obesity, Hypovitaminosis D, and COVID-19: the Bermuda Triangle in Public Health

Curr Obes Rep. 2022 Apr 7. doi: 10.1007/s13679-022-00471-3
Ιrene Karampela 1, Natalia Vallianou 2, Faidon Magkos 3, Caroline M Apovian 4, Μaria Dalamaga 5


Purpose of review: The COVID-19 pandemic has challenged public health to a significant extent by markedly increasing morbidity and mortality. Evidence suggests that obesity and hypovitaminosis D constitute important risk factors for SARS-CoV-2 infection, severity of disease, and poor outcomes. Due to their high prevalence globally, obesity and hypovitaminosis D are considered pandemics. This review presents current epidemiologic and genetic data linking obesity, hypovitaminosis D, and COVID-19, highlighting the importance of the convergence of three pandemics and their impact on public health. We also briefly summarize potential mechanisms that could explain these links.

Recent findings: Epidemiologic data have shown that obesity is an independent risk factor for COVID-19, severe disease and death, and genetic evidence has suggested a causal association between obesity-related traits and COVID-19 susceptibility and severity. Additionally, obesity is independently associated with hypovitaminosis D, which is highly prevalent in subjects with obesity. Hypovitaminosis D is independently associated with a higher risk for COVID-19, severity, hospitalization, infectious complications, acute respiratory distress syndrome, and poor outcomes. However, genome-wide association studies have not revealed any causal association between vitamin D levels and the risk for COVID-19, while there is no robust evidence for a beneficial role of vitamin D supplementation in the prevention and treatment of COVID-19. In the context of the ongoing COVID-19 pandemic, the epidemiologic impact of obesity and hypovitaminosis D is emphasized. Efforts to increase public awareness and reinforce preventive and therapeutic measures against obesity and hypovitaminosis D are strongly required.
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Zafgen Inc. outside of the funded work. CMA reports receiving grant funding from NIH, PCORI and Novo Nordisk out­side of the funded work. No other disclosures are reported.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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82.     Pal R, Banerjee M, Bhadada SK, Shetty AJ, Singh B, Vyas A. Vitamin D supplementation and clinical outcomes in COVID- 19: a systematic review and meta-analysis. J Endocrinol Invest. 2021:1-16. https://doi.org/10.1007/s40618-021-01614-4.

83.     Stroehlein JK, Wallqvist J, Iannizzi C, Mikolajewska A, Metzendorf MI, Benstoem C, et al. Vitamin D supplementa­tion for the treatment of COVID-19: a living systematic review. Cochrane Database Syst Rev. 2021;5:CD015043. https://doi. org/10.1002/14651858.CD015043.

84.     Chen J, Mei K, Xie L, Yuan P, Ma J, Yu P, Zhu W, Zheng C, Liu X. Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve out­comes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs. Nutr J. 2021;20(1):89. https://doi.org/10.1186/s12937-021-00744-y.

85.     Rubin R. Sorting out whether vitamin D deficiency raises COVID-19 risk. JAMA. 2021;325(4):329-30. https://doi.org/ 10.1001/jama.2020.24127.

86.   « Li S, Cao Z, Yang H, Zhang Y, Xu F, Wang Y. Metabolic healthy obesity, vitamin D status, and risk of COVID-19. Aging Dis. 2021;12(1):61-71. https://doi.org/10.14336/AD.2020.1108. This study used data from more than 350,000 UK Biobank partici­pants to investigate whether the addition of metabolic disorders and vitamin D insufficiency increased obesity associations with COVID-19 hospitalization, confirmed COVID-19, and severe COVID-19. The multivariate logistic regression analysis showed that obesity combined with metabolic disorders and hypovitaminosis D is associated with a significantly increased risk of COVID-19 severity, especially in adults 65 years and older.

87.     Dalamaga M, Muscogiuri G, Paganitsa G, Parvouleskou G, Syriou V, Karagkoynis P, et al. Adherence to the Mediterranean diet is an independent predictor of circulating vitamin D levels in normal weight and non-smoker adults: an observational cross­sectional study. Int J Food Sci Nutr. 2021:1-13. https://doi.org/ 10.1080/09637486.2021.1878488.

88.     Belanger MJ, Hill MA, Angelidi AM, Dalamaga M, Sowers JR, Mantzoros CS. Covid-19 and disparities in nutrition and obe­sity. N Engl J Med. 2020;383(11): e69. https://doi.org/10.1056/ NEJMp2021264.


VitaminDWiki - 19 studies in BOTH Virus and Obesity categories

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VitaminDWiki - Overview Obesity and Vitamin D contains


  • Normal weight     Obese     (50 ng = 125 nanomole)

VitaminDWiki - Obesity is associated with low Vitamin D (and treated by D as well) – Aug 2019 contains

Fast weight loss by Obese: Summary of the data as of Sept 2019
1) 50,000 IU Vitamin D weekly for at least 6 months
   If gut problems, should use a gut-friendly form of vitamin D
2) Add calorie restriction diet and light exercise after ~2 months*
   * Vitamin D levels must be above 30ng/ml to help with weight loss
   * Start losing weight 2 months sooner if take a 50,000 IU daily for a week
3) More weight loss if also add Magnesium or cofactors
   30% Improved Vitamin D response with Magnesium - a Vitamin D Cofactor
   Note: Magnesium reduces weight loss by itself as well
   20% improved vitamin D response if also add Omega-3 a Vitamin D Cofactor
  Note: Omega-3 reduces weight loss by itself as well
4) More weight loss if also improve activation of Vitamin D Receptor
   Vitamin D Receptor activator: 0-30% improved Vitamin D response
   Obesity 1.5 X more likely if poor Vitamin D Receptor – meta-analysis Nov 2019
Update Dec 2019 - Dr. Greger plant-based eating (not diet) for both weight loss and health.
  His book does not mention Vitamin D nor Adenovirus

VitaminDWiki – COVID-19 treated by Vitamin D - studies, reports, videos

As of Nov 25, 2022, the VitaminDWiki COVID page had:  19 trial results,   37 meta-analyses and reviews,   Mortality studies   see related:   Governments,   HealthProblems,   Hospitals,  Dark Skins,   26 risk factors are ALL associated with low Vit D,   Recent Virus pages   Fight COVID-19 with 50K Vit D weekly   Vaccines   Take lots of Vitamin D at first signs of COVID   116 COVID Clinical Trials using Vitamin D (08/2022)
5 most-recently changed Virus entries

VitaminDWiki - 9 studies in BOTH Virus and Diabetes categories

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