Complementing herd immunity with a sulforaphane-based diet
Although nutritional epidemiology has been criticized on several fronts, including the inability to measure diet accurately, and for its reliance on observational studies to address etiologic questions35, there seems to be sufficient evidence to raise some conclusions that will require appropriate testing.
Great hope has been placed on herd immunity, cross-immunity and vaccination to provide protection against COVID-19. Unfortunately, herd and cross-immunity may not be very effective, and the development of vaccines is a long process. Until vaccines become available, a simple solution would be to complement the diet with food that may have positive metabolic regulatory and anti-inflammatory effects. It is clear that the ecological studies available in Europe should be confirmed by global studies and by adequate epidemiologic studies. However, proposing a modification of diet before scientific evidence is available is not harmful since these foods are usually, but not always, well-tolerated. An alternative approach would be to evaluate the value of sulforaphane in clinical trials, as recently proposed (Text box 1).2
In conclusion, many factors may play a role in the difference of severity and death rates in COVID-19 in different parts of the world. These factors include trained immunity, cross reactivities with different viruses and other coronaviruses as well as many different dietary measures such as vitamin D levels, short-chain fatty acids, omega 3-rich nutrition. 36,37 Here, the authors propose an additional dietary factor, a suphoraphane-based diet. Further research is required to identify the synergistic effects between all of these anti-inflammatory dietary factors, especially those acting on insulin resistance and Nrf2.
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