“A solid vaccination program is lifesaving, essential, and insufficient,” begins the commentary “Shoring Up Vaccine Efficacy,” which appears today in the American Journal of Medicine. The authors say that in addition to vaccinations, health care workers should recommend plant-based diets to help patients improve their health and decrease vulnerability to COVID-19.
The authors point to a new study of health care workers whose immune response to the Pfizer vaccine was inversely associated with waist circumference. A 2021 study of health care workers in six countries revealed that those following largely plant-based diets had 73% lower odds of developing moderate-to-severe COVID-19, compared with those following other diets.
“This benefit may come from the fact that plant-based diets are associated with significantly lower body weight, lower risk of hypertension, lower plasma lipid levels, and lower risk of diabetes,” says Saray Stancic, MD, director of medical education of the nonprofit Physicians Committee for Responsible Medicine and faculty member of Rutgers New Jersey Medical School. “A healthy vegan diet can benefit a large group of individuals who fail to respond adequately to vaccination yet do not have a classic immunosuppression condition.”
Dr. Stancic authored the commentary with Josh Cullimore, MBChB, MPH, of Brighton and Hove Clinical Commissioning Group in the UK, and Neal Barnard, MD, of the Physicians Committee.
“As of November 18, 2020, more than 60% of COVID-19 hospitalizations were attributable to obesity, hypertension, diabetes, or heart failure,” Dr. Stancic says. “We are suggesting, perhaps surprisingly, that a key, but neglected, part of our immunization strategy should be shoring up the cardiometabolic health of the patient to the extent possible.”
To improve health and decrease vulnerability to COVID-19 and other illness, the authors suggest three key strategies:
- Doctors should encourage patients to improve underlying health conditions, including adopting healthful dietary habits, particularly a renewed emphasis on vegetables, fruits, whole grains, and legumes, and plant-based diets. This recommendation aligns with the June 2021 American Medical Association policy urging governmental leaders to encourage individuals with underlying health conditions associated with COVID-19 morbidity and mortality to see their doctors to institute (or resume) appropriate treatment for those underlying conditions.
- Medical practitioners should refer appropriate patients to registered dietitians as a matter of medical urgency. They should provide nutrition information and code nutrition messaging into their electronic medical records to be automatically given to patients at check out.
- Hospitals should provide information about good nutrition to patients, families, visitors, and staff, and should model it with the foods they serve.
“To make an immunization program work, convincing people to roll up their sleeves for initial immunization and boosters as necessary is one key step,” Dr. Stancic says. “Improving their ability to respond to the vaccine is another. Evidence strongly suggests that urgently addressing underlying health conditions with, for starters, a healthier diet would not only reduce the likelihood of severe infection and death; over time it may also help vaccines to work better.”