Special Issue "Nutrition within and beyond Corona Virus"

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutrition and Public Health".

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editors

Prof. Dr. Carlo Agostoni
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Guest Editor
Clinica Pediatrica, Fondazione IRCCS Cà Granda-Ospedale Maggiore Policlinico, Dipartimento di Scienze Cliniche e di Comunità, Università di Milano, Via della Commenda 9, 20122 Milan, Italy
Interests: nutrition and sustainability; fatty acids in human health and disease; nutrition and sustainability
Special Issues and Collections in MDPI journals
Dr. Gregorio Paolo Milani
Website
Guest Editor
Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
Interests: pediatric nutrition;acute disease and metabolism;electrolytes;acid-base balance;pediatric emergency care

Special Issue Information

Dear Colleagues,

The unexpected and astonishing COVID-19 pandemic that the world has been facing since the end of December 2019 represents an extreme outcome of globalization, which has expanded exponentially in recent decades. In spite of the enormous gathering of scientific data, interpersonal distancing (in various forms and expressions) still represents the most effective and affordable measure for people to adopt. Within this context, nutrition is being affected at all stages of the food chain worldwide. The value of single nutrients in combating viral infections, food safety, changes in the food chain (from the field to the industry and distribution), and the related socioeconomical consequences, as well as new emerging scenarios will be detailed in this issue dedicated to “Nutrition within and beyond coronavirus”. We invite researchers to contribute relevant original manuscripts that increase the knowledge of our audience and pave the way to future research in this field.

Prof. Dr. Carlo Agostoni
Dr. Gregorio Paolo Milani
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2000 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COVID-19
  • Pandemia
  • Nutrition
  • Diet
  • Food
  • Dietary Supplements

Published Papers (12 papers)

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Open AccessArticle
Consumers’ Fears Regarding Food Availability and Purchasing Behaviors during the COVID-19 Pandemic: The Importance of Trust and Perceived Stress
Nutrients 2020, 12(9), 2852; https://doi.org/10.3390/nu12092852 - 17 Sep 2020
Abstract
The present study aimed to investigate whether trust in circulating information and perceived stress are predictors of consumers’ fear of limited access to food as well as predictors of food purchase behaviors during the COVID-19 pandemic. The computer-assisted web interviewing (CAWI) technique was [...] Read more.
The present study aimed to investigate whether trust in circulating information and perceived stress are predictors of consumers’ fear of limited access to food as well as predictors of food purchase behaviors during the COVID-19 pandemic. The computer-assisted web interviewing (CAWI) technique was used to collect data from 1033 Polish adults in March 2020. Logistic regression was used to estimate the likelihood of fear of limited access to food and the likelihood of purchase of larger amounts of food than usual. The likelihood of experiencing fear of limited access to food increased by 16% with higher perceived stress, by 50% with higher trust in “Mass media and friends”, and by 219% with perceived changes in food availability in the previous month. Trust in “Polish government institutions” decreased the chance of experiencing such fears by 22%. The likelihood of purchasing larger quantities of food than usual increased by 9% with higher perceived stress, by 46% with higher trust in “Mass media and friends”, by 81% with perceived changes in food availability in the last month, and by 130% with fears of limited access to food as the pandemic spreads. Government institutions may have difficulty in disseminating pandemic-related recommendations through media, not only due to relatively low trust people have in media organizations but also due to the increasing likelihood of the occurrence of both fears regarding food availability and panic-stricken food-buying behaviors with increase in trust in this source of information. Therefore, it is necessary to develop interventions that will reduce perceived stress and improve the trust in information from reputable sources. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
Open AccessArticle
Prevalence and Socio-Demographic Predictors of Food Insecurity in Australia during the COVID-19 Pandemic
Nutrients 2020, 12(9), 2682; https://doi.org/10.3390/nu12092682 - 02 Sep 2020
Abstract
The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed [...] Read more.
The COVID-19 pandemic has exacerbated economic vulnerabilities and disrupted the Australian food supply, with potential implications for food insecurity. This study aims to describe the prevalence and socio-demographic associations of food insecurity in Tasmania, Australia, during the COVID-19 pandemic. A cross-sectional survey (deployed late May to early June 2020) incorporated the U.S. Household Food Security Survey Module: Six-Item Short Form, and fifteen demographic and COVID-related income questions. Survey data (n = 1170) were analyzed using univariate and multivariate binary logistic regression. The prevalence of food insecurity was 26%. The adjusted odds of food insecurity were higher among respondents with a disability, from a rural area, and living with dependents. Increasing age, a university education, and income above $80,000/year were protective against food insecurity. Food insecurity more than doubled with a loss of household income above 25% (Adjusted Odds Ratio (AOR): 2.02; 95% CI: 1.11, 3.71; p = 0.022), and the odds further increased with loss of income above 75% (AOR: 7.14; 95% CI: 2.01, 24.83; p = 0.002). Our results suggest that the prevalence of food insecurity may have increased during the COVID-19 pandemic, particularly among economically vulnerable households and people who lost income. Policies that support disadvantaged households and ensure adequate employment opportunities are important to support Australians throughout and post the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Population-Based Study of the Changes in the Food Choice Determinants of Secondary School Students: Polish Adolescents’ COVID-19 Experience (PLACE-19) Study
Nutrients 2020, 12(9), 2640; https://doi.org/10.3390/nu12092640 - 30 Aug 2020
Abstract
During the outbreak of Coronavirus Disease 2019 (COVID-19) pandemic and the lockdown, various changes of dietary habits are observed, including both positive and negative ones. However, the food choice determinants in this period were not studied so far for children and adolescents. The [...] Read more.
During the outbreak of Coronavirus Disease 2019 (COVID-19) pandemic and the lockdown, various changes of dietary habits are observed, including both positive and negative ones. However, the food choice determinants in this period were not studied so far for children and adolescents. The study aimed to analyze the changes in the food choice determinants of secondary school students in a national sample of Polish adolescents within the Polish Adolescents’ COVID-19 Experience (PLACE-19) Study population. The study was conducted in May 2020, based on the random quota sampling of schools (for voivodeships and counties) and a number of 2448 students from all the regions of Poland participated. The Food Choice Questionnaire (FCQ) (36 items) was applied twice—to analyze separately current choices (during the period of COVID-19 pandemic) and general choices (when there was no COVID-19 pandemic). For both the period before and during the COVID-19 pandemic, sensory appeal and price were indicated as the most important factors (with the highest scores). However, differences were observed between the scores of specific factors, while health (p < 0.0001) and weight control (p < 0.0001) were declared as more important during the period of COVID-19 pandemic, compared with the period before, but mood (p < 0.0001) and sensory appeal (p < 0.0001) as less important. The observations were confirmed for sub-groups, while female and male respondents were analyzed separately. It can be concluded that the COVID-19 pandemic may have changed the food choice determinants of Polish adolescents, as it may have increased the importance of health and weight control, but reduced the role of mood and sensory appeal. This may be interpreted as positive changes promoting the uptake of a better diet than in the period before the pandemic. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Vitamin D Insufficiency and Deficiency and Mortality from Respiratory Diseases in a Cohort of Older Adults: Potential for Limiting the Death Toll during and beyond the COVID-19 Pandemic?
Nutrients 2020, 12(8), 2488; https://doi.org/10.3390/nu12082488 - 18 Aug 2020
Abstract
The COVID-19 pandemic goes along with increased mortality from acute respiratory disease. It has been suggested that vitamin D3 supplementation might help to reduce respiratory disease mortality. We assessed the prevalence of vitamin D insufficiency and deficiency, defined by 25-hydroxyvitamin D (25(OH)D) [...] Read more.
The COVID-19 pandemic goes along with increased mortality from acute respiratory disease. It has been suggested that vitamin D3 supplementation might help to reduce respiratory disease mortality. We assessed the prevalence of vitamin D insufficiency and deficiency, defined by 25-hydroxyvitamin D (25(OH)D) blood levels of 30–50 and <30 nmol/L, respectively, and their association with mortality from respiratory diseases during 15 years of follow-up in a cohort of 9548 adults aged 50–75 years from Saarland, Germany. Vitamin D insufficiency and deficiency were common (44% and 15%, respectively). Compared to those with sufficient vitamin D status, participants with vitamin D insufficiency and deficiency had strongly increased respiratory mortality, with adjusted hazard ratios (95% confidence intervals) of 2.1 (1.3–3.2) and 3.0 (1.8–5.2) overall, 4.3 (1.3–14.4) and 8.5 (2.4–30.1) among women, and 1.9 (1.1–3.2) and 2.3 (1.1–4.4) among men. Overall, 41% (95% confidence interval: 20–58%) of respiratory disease mortality was statistically attributable to vitamin D insufficiency or deficiency. Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory disease mortality in older adults, supporting the hypothesis that vitamin D3 supplementation could be helpful to limit the burden of the COVID-19 pandemic, particularly among women. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
The Impact of COVID-19 on Health Behavior, Stress, Financial and Food Security among Middle to High Income Canadian Families with Young Children
Nutrients 2020, 12(8), 2352; https://doi.org/10.3390/nu12082352 - 07 Aug 2020
Abstract
The COVID-19 pandemic has disrupted many aspects of daily life. The purpose of this study was to identify how health behaviors, level of stress, financial and food security have been impacted by the pandemic among Canadian families with young children. Parents (mothers, n [...] Read more.
The COVID-19 pandemic has disrupted many aspects of daily life. The purpose of this study was to identify how health behaviors, level of stress, financial and food security have been impacted by the pandemic among Canadian families with young children. Parents (mothers, n = 235 and fathers, n = 126) from 254 families participating in an ongoing study completed an online survey that included close and open-ended questions. Descriptive statistics were used to summarize the quantitative data and qualitative responses were analyzed using thematic analysis. More than half of our sample reported that their eating and meal routines have changed since COVID-19; most commonly reported changes were eating more snack foods and spending more time cooking. Screen time increased among 74% of mothers, 61% of fathers, and 87% of children and physical activity decreased among 59% of mothers, 52% of fathers, and 52% of children. Key factors influencing family stress include balancing work with childcare/homeschooling and financial instability. While some unhealthful behaviors appeared to have been exacerbated, other more healthful behaviors also emerged since COVID-19. Research is needed to determine the longer-term impact of the pandemic on behaviors and to identify effective strategies to support families in the post-COVID-19 context. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Dietary and Lifestyle Changes During COVID-19 and the Subsequent Lockdowns among Polish Adults: A Cross-Sectional Online Survey PLifeCOVID-19 Study
Nutrients 2020, 12(8), 2324; https://doi.org/10.3390/nu12082324 - 03 Aug 2020
Cited by 4
Abstract
The present study aimed to identify patterns of dietary changes during the COVID-19 pandemic and their associations with sociodemographics, body mass index (BMI) before pandemic, and lifestyle changes in Polish adults and to examine the effects of lockdowns on dietary–lifestyle changes. This study [...] Read more.
The present study aimed to identify patterns of dietary changes during the COVID-19 pandemic and their associations with sociodemographics, body mass index (BMI) before pandemic, and lifestyle changes in Polish adults and to examine the effects of lockdowns on dietary–lifestyle changes. This study used a cross-sectional online survey to collect data. The k-means algorithm was used to determine of patterns of dietary changes, and logistic regression analyses were performed. During the study period, 43% of respondents decreased physical activity (PA), 49%—increased screen time, and 34%—increased food consumption. Among the three dietary changes patterns, two opposite patterns were found: Prohealthy (28% participants) and Unhealthy (19% participants).The adherence to the Prohealthy pattern was negatively associated with age, but positively with being overweight (aOR 1.31) or obese before pandemic (aOR 1.64). Residing in a macroeconomic region with GDP > 100% decreased adherence to the Prohealthy (aOR 0.73) but increased adherence to the Unhealthy pattern (aOR 1.47). Adults over 40 years old, those living with children, unemployed, those living in a region with a higher GDP, and those not consuming homemade meals could be more exposed to unhealthy behaviors. From a public health perspective, enhancing the message “to be active” during the compulsory isolation period should be prioritized. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Changes of Physical Activity and Ultra-Processed Food Consumption in Adolescents from Different Countries during Covid-19 Pandemic: An Observational Study
Nutrients 2020, 12(8), 2289; https://doi.org/10.3390/nu12082289 - 30 Jul 2020
Cited by 2
Abstract
Aim: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. Methods: Cross-sectional study via web survey. International Physical Activity [...] Read more.
Aim: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. Methods: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. Results: Sample of 726 adolescents, mostly females (59.6%) aged 16–19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80–4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20–0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. Conclusion: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Psychological Aspects and Eating Habits during COVID-19 Home Confinement: Results of EHLC-COVID-19 Italian Online Survey
Nutrients 2020, 12(7), 2152; https://doi.org/10.3390/nu12072152 - 19 Jul 2020
Cited by 1
Abstract
The COVID-19 pandemic has had a huge impact on the population with consequences on lifestyles. The aim of the study was to analyse the relationship between eating habits, mental and emotional mood. A survey was conducted online during social isolation, from 24 April [...] Read more.
The COVID-19 pandemic has had a huge impact on the population with consequences on lifestyles. The aim of the study was to analyse the relationship between eating habits, mental and emotional mood. A survey was conducted online during social isolation, from 24 April to 18 May 2020, among the Italian population. A total of 602 interviewees were included in the data analysis. A high percentage of respondents experienced a depressed mood, anxious feelings, hypochondria and insomnia (61.3%, 70.4%, 46.2% and 52.2%). Almost half of the respondents felt anxious due to the fact of their eating habits, consumed comfort food and were inclined to increase food intake to feel better. Age was inversely related to dietary control (OR = 0.971, p = 0.005). Females were more anxious and disposed to comfort food than males (p < 0.001; p < 0.001). A strength of our study was represented by the fact that the survey was conducted quickly during the most critical period of the Italian epidemic lockdown. As the COVID-19 pandemic is still ongoing, our data need to be confirmed and investigated in the future with larger population studies. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
The Early Food Insecurity Impacts of COVID-19
Nutrients 2020, 12(7), 2096; https://doi.org/10.3390/nu12072096 - 15 Jul 2020
Cited by 2
Abstract
COVID-19 has disrupted food access and impacted food insecurity, which is associated with numerous adverse individual and public health outcomes. To assess these challenges and understand their impact on food security, we conducted a statewide population-level survey using a convenience sample in Vermont [...] Read more.
COVID-19 has disrupted food access and impacted food insecurity, which is associated with numerous adverse individual and public health outcomes. To assess these challenges and understand their impact on food security, we conducted a statewide population-level survey using a convenience sample in Vermont from 29 March to 12 April 2020, during the beginning of a statewide stay-at-home order. We utilized the United States Department of Agriculture six-item validated food security module to measure food insecurity before COVID-19 and since COVID-19. We assessed food insecurity prevalence and reported food access challenges, coping strategies, and perceived helpful interventions among food secure, consistently food insecure (pre-and post-COVID-19), and newly food insecure (post COVID-19) respondents. Among 3219 respondents, there was nearly a one-third increase (32.3%) in household food insecurity since COVID-19 (p < 0.001), with 35.5% of food insecure households classified as newly food insecure. Respondents experiencing a job loss were at higher odds of experiencing food insecurity (OR 3.06; 95% CI, 2.114–0.46). We report multiple physical and economic barriers, as well as concerns related to food access during COVID-19. Respondents experiencing household food insecurity had higher odds of facing access challenges and utilizing coping strategies, including two-thirds of households eating less since COVID-19 (p < 0.001). Significant differences in coping strategies were documented between respondents in newly food insecure vs. consistently insecure households. These findings have important potential impacts on individual health, including mental health and malnutrition, as well as on future healthcare costs. We suggest proactive strategies to address food insecurity during this crisis. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Covid-19 Confinement and Changes of Adolescent’s Dietary Trends in Italy, Spain, Chile, Colombia and Brazil
Nutrients 2020, 12(6), 1807; https://doi.org/10.3390/nu12061807 - 17 Jun 2020
Cited by 6
Abstract
Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents’ poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim [...] Read more.
Confinement due to the COVID-19 pandemic can influence dietary profiles, especially those of adolescents, who are highly susceptible to acquiring bad eating habits. Adolescents’ poor dietary habits increase their subsequent risk of degenerative diseases such as obesity, diabetes, cardiovascular pathologies, etc. Our aim was to study nutritional modifications during COVID-19 confinement in adolescents aged 10 to 19 years, compare them with their usual diet and dietary guidelines, and identify variables that may have influenced changes. Data were collected by an anonymous online questionnaire on food intake among 820 adolescents from Spain, Italy, Brazil, Colombia, and Chile. The results show that COVID-19 confinement did influence their dietary habits. In particular, we recorded modified consumption of fried food, sweet food, legumes, vegetables, and fruits. Moreover, gender, family members at home, watching TV during mealtime, country of residence, and maternal education were diversely correlated with adequate nutrition during COVID-19 confinement. Understanding the adolescents’ nutrition behavior during COVID-19 lockdown will help public health authorities reshape future policies on their nutritional recommendations, in preparation for future pandemics. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Open AccessArticle
Dietary Choices and Habits during COVID-19 Lockdown: Experience from Poland
Nutrients 2020, 12(6), 1657; https://doi.org/10.3390/nu12061657 - 03 Jun 2020
Cited by 15
Abstract
The outbreak of coronavirus disease (COVID-19) in late December 2019 in China, which later developed into a pandemic, has forced different countries to implement strict sanitary regimes and social distancing measures. Globally, at least four billion people were under lockdown, working remotely, homeschooling [...] Read more.
The outbreak of coronavirus disease (COVID-19) in late December 2019 in China, which later developed into a pandemic, has forced different countries to implement strict sanitary regimes and social distancing measures. Globally, at least four billion people were under lockdown, working remotely, homeschooling children, and facing challenges coping with quarantine and the stressful events. The present cross-sectional online survey of adult Poles (n = 1097), conducted during a nationwide quarantine, aimed to assess whether nutritional and consumer habits have been affected under these conditions. Over 43.0% and nearly 52% reported eating and snacking more, respectively, and these tendencies were more frequent in overweight and obese individuals. Almost 30% and over 18% experienced weight gain (mean ± SD 3.0 ± 1.6 kg) and loss (−2.9 ± 1.5 kg), respectively. Overweight, obese, and older subjects (aged 36–45 and >45) tended to gain weight more frequently, whereas those with underweight tended to lose it further. Increased BMI was associated with less frequent consumption of vegetables, fruit, and legumes during quarantine, and higher adherence to meat, dairy, and fast-foods. An increase in alcohol consumption was seen in 14.6%, with a higher tendency to drink more found among alcohol addicts. Over 45% of smokers experienced a rise in smoking frequency during the quarantine. The study highlights that lockdown imposed to contain an infectious agent may affect eating behaviors and dietary habits, and advocates for organized nutritional support during future epidemic-related quarantines, particularly for the most vulnerable groups, including overweight and obese subjects. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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Review

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Open AccessReview
Antiviral Functional Foods and Exercise Lifestyle Prevention of Coronavirus
Nutrients 2020, 12(9), 2633; https://doi.org/10.3390/nu12092633 - 28 Aug 2020
Abstract
Novel coronavirus (COVID-19) is causing global mortality and lockdown burdens. A compromised immune system is a known risk factor for all viral influenza infections. Functional foods optimize the immune system capacity to prevent and control pathogenic viral infections, while physical activity augments such [...] Read more.
Novel coronavirus (COVID-19) is causing global mortality and lockdown burdens. A compromised immune system is a known risk factor for all viral influenza infections. Functional foods optimize the immune system capacity to prevent and control pathogenic viral infections, while physical activity augments such protective benefits. Exercise enhances innate and adaptive immune systems through acute, transient, and long-term adaptations to physical activity in a dose-response relationship. Functional foods prevention of non-communicable disease can be translated into protecting against respiratory viral infections and COVID-19. Functional foods and nutraceuticals within popular diets contain immune-boosting nutraceuticals, polyphenols, terpenoids, flavonoids, alkaloids, sterols, pigments, unsaturated fatty-acids, micronutrient vitamins and minerals, including vitamin A, B6, B12, C, D, E, and folate, and trace elements, including zinc, iron, selenium, magnesium, and copper. Foods with antiviral properties include fruits, vegetables, fermented foods and probiotics, olive oil, fish, nuts and seeds, herbs, roots, fungi, amino acids, peptides, and cyclotides. Regular moderate exercise may contribute to reduce viral risk and enhance sleep quality during quarantine, in combination with appropriate dietary habits and functional foods. Lifestyle and appropriate nutrition with functional compounds may offer further antiviral approaches for public health. Full article
(This article belongs to the Special Issue Nutrition within and beyond Corona Virus)
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