Abstract
In this editorial, Roger Kirby, Editor‐in‐Chief for Trends in Urology and Men's Health, discusses why the association between obesity and higher‐risk COVID‐19 infection needs to be taken seriously as we get increasingly close to winter, the prime flu season.
Obesity is one of the biggest health crises that the world faces. Almost two‐thirds (63%) of adults in England are either overweight or living with obesity, and one in three children leave primary school overweight or obese – obesity‐related illnesses costs the NHS £6 billion a year.
Trends in Urology and Men's Health has been campaigning to persuade men to help themselves by losing weight for more than a decade. Over the years our ‘getting to a better PLACE’ (Portion control, Lose the booze, Axe the snacks, Cut the carbs, Exercise every day) mnemonic has proved to be a helpful prompt for many individuals.
Recently, a raft of measures have been revealed as part of the government's new obesity strategy to get the nation healthy, including:
A ban on TV and online adverts before 9pm for food high in fat, sugar and salt
End of deals like ‘buy one get one free’ on unhealthy food high in salt, sugar and fat
Calories to be displayed on menus to help people make healthier choices when eating out, while alcoholic drinks could soon have to list hidden ‘liquid calories’.
Although these initiatives are to be applauded, an extension of a ‘sugar tax’ beyond sweet drinks would likely be a more effective way of achieving weight reduction in the population. Children are watching only half as much commercial television as they were a decade ago, and online advertising is much harder to regulate because YouTube, unlike a broadcaster, is not legally responsible for the adverts it carries.
Furthermore, a Cochrane review of the evidence of the effectiveness of nutritional labelling found that it only had a minor impact on consumption, while two recent studies by researchers from the University of Cambridge found that posting calorie counts in workplace cafeterias made no difference to eating habits.
The greatest incentive to shed some weight may now stem from the so‐called COVID‐19 ‘wake‐up call’. Living with excess weight puts people, especially men, at greater risk of serious illness or death from COVID‐19, with risk growing substantially as body mass index (BMI) increases. Nearly 8% of the critically ill patients with COVID‐19 in intensive care units have been morbidly obese, compared with 2.9% of the general population. A recent survey found high levels of concern about a ‘second wave’ of COVID‐19, with 75% of those questioned saying they expected a further outbreak later this year. Considering the significant risk of a second spike during the coming months there has never been a better time to persuade people to focus on weight reduction and improved fitness.
Bearing in mind that following the first wave of the 1918–1919 H1N1 influenza pandemic, subsequent spikes afflicted a different population demographic, namely young adults, we cannot assume that further waves of COVID‐19 will largely confine themselves to the elderly. Young and middle‐aged folk also need to beware – ‘winter is coming’ – and there has never been a better time to ‘get on your bike’!