LETTERS
Nutrition and Clinical Services Division,
icddr,b, 68, Shaheed Tajuddin Ahmed
Sarani Mohakhali, Dhaka 1212,
Bangladesh
syed.ahmed@icddrb.org
Cite this as: BMJ 2020;370:m2811
http://dx.doi.org/10.1136/bmj.m2811
Published: 14 July 2020
the bmj | BMJ 2020;370:m2811 | doi: 10.1136/bmj.m2811
OBESITY AND COVID-19
Obesity is a potential risk factor for covid-19 associated morbidity
and mortality in urban Bangladesh
Syed Imran Ahmed, S M Tafsir Hasan, Tahmeed Ahmed
Tan and colleagues investigate the link between 4 Institute of Epidemiology Disease Control and Research. Bangladesh
obesity and covid-19.1 covid-19 update. https://iedcr.gov.bd.
5 Mamun S. Govt for strictly enforcing travel ban as general holiday extends
Rates of overweight and obesity—a pre-eminent to May 30. Dhaka Tribune. 14 May 2020. www.dhakatri-
public health problem of the modern world—are bune.com/bangladesh/2020/05/14/govt-for-strictly-enforcing-travel-ban-
as-general-holiday-extended-till-may-30.
growing in Bangladesh,2 and are probably an
6 Lippi G, Henry BM, Sanchis-Gomar F. Physical inactivity and cardiovascular
underlying factor in the high rate of covid-19
disease at the time of coronavirus disease 2019 (COVID-19). Eur J Prev
associated morbidity and mortality in the country. Cardiol 2020;27:906-8. doi: 10.1177/2047487320916823 pmid: 32270698
By 19 June, 90 619 covid-19 cases have been 7 Sidor A, Rzymski P. Dietary choices and habits during covid-19 lockdown:
identified,3 mostly concentrated in urban areas.4 As experience from Poland. Nutrients 2020;12:1657.
a result of the government’s actions—such as doi: 10.3390/nu12061657 pmid: 32503173
8 Gluck ME, Geliebter A, Satov T. Night eating syndrome is associated with
enforcing lockdown, shutting down educational
depression, low self-esteem, reduced daytime hunger, and less weight loss
institutions and offices, and putting restrictions on in obese outpatients. Obes Res 2001;9:264-7.
the movement of vehicles5—people in urban doi: 10.1038/oby.2001.31 pmid: 11331430
communities are staying at home, reducing mobility 9 Banik R, Naher S, Pervez S. Fast food consumption and obesity among
and physical activity.6 Furthermore, being confined urban college going adolescents in Bangladesh: a cross-sectional study.
Obes Med. 2020;17:doi: 10.1016/j.obmed.2019.100161.
at home, people have indulged in binge eating,7
10 Ali ANMA. Food safety and public health issues in Bangladesh: a regulatory
which may be linked to the increase in depressive concern. Eur Food Feed Law Rev 2013;8:31-40.
illnesses amid the pandemic.8 Regardless of the 11 Samartín S, Chandra RK. Obesity, overnutrition, and the immune system.
pandemic, 68% of urban college students in the Nutr Res 2001;21:243-62doi: 10.1016/S0271-5317(00)00255-4.
country consume fast food regularly, and 29.9% of
them are obese.9 Processed food industries and
restaurants are loosely regulated in Bangladesh, and
the nutritional value of food is often overlooked.10
All these factors are leading to increased overweight
and obesity, which is associated with weakened
immunity.11
Early reports indicate a substantial epidemiological
shift in vulnerable age groups for covid-19 in
Bangladesh compared with other countries. Although
older people are still at risk, nearly 70% of cases and
22% of all deaths are among people aged 20-50 years,
the age group with the highest prevalence of
overweight and obesity.3 We presume that the high
prevalence of overweight and obesity among urban
people has played a critical role in increased
morbidity and mortality in covid-19 by lowering
immunity.
There is a dire need for large scale epidemiological
studies to investigate this association as well as
public health programmes to improve knowledge
and practice in order to reduce obesity among urban
populations through healthy eating and exercise.
Competing interests: None declared.
Full response at: www.bmj.com/content/369/bmj.m2237/rr-3.
1 Tan M, He FJ, MacGregor GA. Obesity and covid-19: the role of the food
industry. BMJ 2020;369:m2237. doi: 10.1136/bmj.m2237 pmid: 32522740
2 Banik S, Rahman M. Prevalence of overweight and obesity in Bangladesh:
a systematic review of the literature. Curr Obes Rep 2018;7:247-53.
doi: 10.1007/s13679-018-0323-x pmid: 30349968
3 WHO. Bangladesh covid-19 situation reports. June 2020.
www.who.int/docs/default-source/searo/bangladesh/covid-19-who-
bangladesh-situation-reports/who-covid-19-update-16-20200615.pdf.
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