Research Article	The Effect of COVID-19 Pandemic on Dietary Food Supplement Usage Habits COVID-19 Salgınının Besin Takviyesi Kullanım Alışkanlıklarına Etkisi *Mehmet AĞILLI^1 [ID], Alpaslan COŞAR^1[ID] Abstract With COVID-19 pandemic, it is seen that people are in demand for dietary food supplements in order to protect themselves from this virus-related disease. In this study, we aimed to evaluate what extent the COVID-19 pandemic affects people's food supplement usage habits by controlling blood levels of vitamin D, vitamin B12 and zinc. In this retrospective study design, we examined patients test results collected from laboratory information system over a two-year period including one year before and after the date of first COVID-19 infection in Türkiye. There were 197,669 eligible test results for statistical evaluation. Mean vitamin D levels for preCOVID group spring, summer, autumn and winter were 22.3, 25.2, 25.4, and 21.9 ng/mL, respectively. As for the postCOVID group, identical values were 21.3, 22.7, 23.8, and 24.4 ng/mL. For vitamin D levels, there were statistically differences between subgroups (seasons) but no difference between main groups (p>0.05). Mean vitamin B12 levels were 262.6 pg/mL and 264.1 pg/mL (p>0.05), and mean zinc levels were 84.0 µg/dL and 91.1 µg/dL (p<0.001) for preCOVID and postCOVID groups, respectively. In recent years, as integrative medicine has become popular all over the world, interest in dietary food supplements has started to climb. The belief on such food supplements increase protection against viral diseases suggested that the increased usage of these products in the pandemic period. In this study, except zinc there was no statistically difference between pre and postCOVID periods in terms of serum levels. The results showed us the change of supplement usage behavior due to COVID-19 is suspicious. Keywords: COVID-19, Dietary food supplement, Vitamin D, Vitamin B12, Zinc. Özet COVID-19 salgınıyla birlikte insanların bu viral hastalıktan korunmak için diyet gıda takviyelerine talep gösterdiği görülmektedir. Bu çalışmada, D vitamini, B12 vitamini ve çinko kan seviyelerini kontrol ederek, COVID-19 salgınının insanların gıda takviyesi kullanım alışkanlıklarını ne ölçüde etkilediğini değerlendirmeyi amaçladık. Bu retrospektif çalışma tasarımında, Türkiye'de ilk COVID-19 enfeksiyonunun görüldüğü tarihten bir yıl öncesini ve sonrasını kapsayan iki yıllık bir süre boyunca hastaların laboratuvar bilgi sisteminden toplanan test sonuçlarını inceledik. İstatistiksel değerlendirme için 197.669 uygun test sonucu vardı. COVID öncesi grup için ortalama D vitamini düzeyleri ilkbahar, yaz, sonbahar ve kış sırasıyla 22.3, 25.2, 25.4 ve 21.9 ng/mL idi. COVID sonrası grupta ise aynı değerler 21.3, 22.7, 23.8 ve 24.4 ng/mL idi. D vitamini düzeyleri için alt gruplar (mevsimler) arasında istatistiksel olarak fark vardı, ancak ana gruplar arasında fark yoktu (p>0,05). Ortalama B12 vitamini seviyeleri, COVID öncesi ve COVID sonrası gruplar için sırasıyla 262.6 pg/mL ve 264.1 pg/mL (p>0.05) ve ortalama çinko seviyeleri ise 84.0 µg/dL ve 91.1 µg/dL idi (p<0.001). Son yıllarda bütünleştirici tıbbın tüm dünyada popüler hale gelmesiyle birlikte diyet gıda takviyelerine olan ilgi de artmaya başladı. Bu tür gıda takviyelerinin viral hastalıklara karşı korumayı arttırdığına dair inanç, bu ürünlerin pandemi döneminde kullanımının arttığını düşündürmektedir. Bu çalışmada çinko dışında serum düzeyleri açısından COVID öncesi ve sonrası dönemler arasında istatistiksel olarak bir fark bulunmadı. Sonuçlar bize, COVID-19 nedeniyle besin takviyesi kullanım davranışındaki değişikliğin şüpheli olduğunu gösterdi. Anahtar kelimeler: COVID-19, Besin takviyesi, D vitamini, B12 vitamini, Çinko. Introduction The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has affected millions of people worldwide and caused coronavirus disease 2019 (COVID-19) pandemic [1]. The ongoing studies provide promising results but still a definitive treatment could not be discovered for an infected person. Several drugs such as remdesivir, hydroxychloroquine, chloroquine, ribavirin, ritonavir, lopinavir, favipiravir, interferons, tocilizumab, azithromycin, etc. are either have been tried and given up or still being in treatment protocol [2]. The best offer for protection from virus seems “not to be infected”, in this respect, people rely upon newly developed vaccines. Adding to vaccines, dietary food supplements also take place in terms of boosting or strengthening immune defense with the aim of not to be infected [3]. For that purpose, almost all dietary food supplements gain popularity, lots of them have been incorporated into scientific study designs. The main ones are vitamin D, zinc, vitamin C, omega-3 fatty acids, curcumin, cinnamaldehyde, probiotics, selenium, quercetin, vitamin B12, lactoferrin, vitamin B-complex, etc. [4,5]. Vitamin D is considered to be an important factor in immune homeostasis [6]. Vitamin D strengthens cellular immunity, reduces cytokine storm and improves antioxidants production [7]. Also, vitamin D has modulatory effects on angiotensin-converting enzyme 2 (ACE-2) receptors which takes place in SARS-CoV-2 infection pathogenesis, and potential protective functions toward acute lung injuries, including severe COVID-19 [6]. Lots of studies were designed to present the linkage between vitamin D and COVID-19. Zinc is one of the most significant essential trace elements affecting immunological resistance [5,8]. From the viewpoint of COVID-19’s pathophysiological mechanism; zinc inhibits T‐cell activation and macrophage infiltration, thereby attenuating production of pro‐inflammatory cytokine, lung inflammation and ultimately, cytokine storm, oxidative stress and organ damage [9]. Beside zinc, vitamin B types (B1, B2, B3, B5, B6, B9 and B12) have been thought to take place in COVID-19 infection pathogenesis and clinical presentations in terms of adaptive immunity, viral replication, cytokine storm and hypercoagulability [4,10]. Dietary food supplement popularity has been increased all over the world since outbreak of pandemic [11]. Supplementation with several micronutrients was proposed because of its potentially beneficial effects for COVID-19 infected individuals [12]. In this study, we aimed to investigate whether COVID-19 pandemic affected dietary food supplement intake habits of a restricted area in Turkey. Material and Method Ethical approval was obtained from local ethics committee (Date: 02.03.2022. Decision number: 2022/24). Study setting and participants In this retrospective data analysis, we examined the data collected from the laboratory information system (LIS). The date of 11 March 2020 was the first COVID-19 case in Turkey. Therefore, this date was selected as the center point and the collected data comprised one year before and after this point. Naturally, we had two groups; the first group consists of the period before COVID infection (named as preCOVID group; Group 1) and the second group consists of the period after COVID infection (named as postCOVID group; Group 2). Vitamin D, zinc, and vitamin B12 results were drawn from LIS. Patient results originated from oncology, hematology and nephrology clinics were excluded from the study. Also, results from other clinics of patients with all vitamin deficiencies, pregnancy, rachitism and hyperparathyroidism were also eliminated. Lastly, we excluded under 18 and over 90 years old participants. To read more, see the pdf format of the article ...
DOI: 10.46683/jmvi.2024.86
Article in English
^1Department of Medical Biochemistry, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye.
*Corresponding author Mehmet Ağıllı; MD., Department of Medical Biochemistry, Gulhane Training and Research Hospital, University of Health Sciences, Ankara, Türkiye. E-mail: mehmetagilli@yahoo.com
Received: 19.11.2023 Accepted: 28.12.2023 Published: 02.01.2024
Cite as: Ağıllı M, Coşar A. The Effect of COVID-19 Pandemic on Dietary Food Supplement Usage Habits. J Mol Virol Immunol 2024; 5(1): 16-22.
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