The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19

Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Daan L. de Frel [verfasserIn] Douwe E. Atsma [verfasserIn] Hanno Pijl [verfasserIn] Jacob C. Seidell [verfasserIn] Pieter J. M. Leenen [verfasserIn] Willem A. Dik [verfasserIn] Elisabeth F. C. van Rossum [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	obesity diet COVID-19 lifestyle immune system

Übergeordnetes Werk:	In: Frontiers in Nutrition - Frontiers Media S.A., 2014, 7(2020)
Übergeordnetes Werk:	volume:7 ; year:2020

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.3389/fnut.2020.597600

Katalog-ID:	DOAJ016975286

Internformat


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Indexfelder

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allfields	10.3389/fnut.2020.597600 doi (DE-627)DOAJ016975286 (DE-599)DOAJ62b71c0abfba4d098c77a00d6ad3a82b DE-627 ger DE-627 rakwb eng TX341-641 Daan L. de Frel verfasserin aut The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2. obesity diet COVID-19 lifestyle immune system Nutrition. Foods and food supply Douwe E. Atsma verfasserin aut Hanno Pijl verfasserin aut Jacob C. Seidell verfasserin aut Pieter J. M. Leenen verfasserin aut Willem A. Dik verfasserin aut Willem A. Dik verfasserin aut Elisabeth F. C. van Rossum verfasserin aut Elisabeth F. C. van Rossum verfasserin aut In Frontiers in Nutrition Frontiers Media S.A., 2014 7(2020) (DE-627)790231158 (DE-600)2776676-7 2296861X nnns volume:7 year:2020 https://doi.org/10.3389/fnut.2020.597600 kostenfrei https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b kostenfrei https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full kostenfrei https://doaj.org/toc/2296-861X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
spelling	10.3389/fnut.2020.597600 doi (DE-627)DOAJ016975286 (DE-599)DOAJ62b71c0abfba4d098c77a00d6ad3a82b DE-627 ger DE-627 rakwb eng TX341-641 Daan L. de Frel verfasserin aut The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2. obesity diet COVID-19 lifestyle immune system Nutrition. Foods and food supply Douwe E. Atsma verfasserin aut Hanno Pijl verfasserin aut Jacob C. Seidell verfasserin aut Pieter J. M. Leenen verfasserin aut Willem A. Dik verfasserin aut Willem A. Dik verfasserin aut Elisabeth F. C. van Rossum verfasserin aut Elisabeth F. C. van Rossum verfasserin aut In Frontiers in Nutrition Frontiers Media S.A., 2014 7(2020) (DE-627)790231158 (DE-600)2776676-7 2296861X nnns volume:7 year:2020 https://doi.org/10.3389/fnut.2020.597600 kostenfrei https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b kostenfrei https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full kostenfrei https://doaj.org/toc/2296-861X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfields_unstemmed	10.3389/fnut.2020.597600 doi (DE-627)DOAJ016975286 (DE-599)DOAJ62b71c0abfba4d098c77a00d6ad3a82b DE-627 ger DE-627 rakwb eng TX341-641 Daan L. de Frel verfasserin aut The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2. obesity diet COVID-19 lifestyle immune system Nutrition. Foods and food supply Douwe E. Atsma verfasserin aut Hanno Pijl verfasserin aut Jacob C. Seidell verfasserin aut Pieter J. M. Leenen verfasserin aut Willem A. Dik verfasserin aut Willem A. Dik verfasserin aut Elisabeth F. C. van Rossum verfasserin aut Elisabeth F. C. van Rossum verfasserin aut In Frontiers in Nutrition Frontiers Media S.A., 2014 7(2020) (DE-627)790231158 (DE-600)2776676-7 2296861X nnns volume:7 year:2020 https://doi.org/10.3389/fnut.2020.597600 kostenfrei https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b kostenfrei https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full kostenfrei https://doaj.org/toc/2296-861X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfieldsGer	10.3389/fnut.2020.597600 doi (DE-627)DOAJ016975286 (DE-599)DOAJ62b71c0abfba4d098c77a00d6ad3a82b DE-627 ger DE-627 rakwb eng TX341-641 Daan L. de Frel verfasserin aut The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2. obesity diet COVID-19 lifestyle immune system Nutrition. Foods and food supply Douwe E. Atsma verfasserin aut Hanno Pijl verfasserin aut Jacob C. Seidell verfasserin aut Pieter J. M. Leenen verfasserin aut Willem A. Dik verfasserin aut Willem A. Dik verfasserin aut Elisabeth F. C. van Rossum verfasserin aut Elisabeth F. C. van Rossum verfasserin aut In Frontiers in Nutrition Frontiers Media S.A., 2014 7(2020) (DE-627)790231158 (DE-600)2776676-7 2296861X nnns volume:7 year:2020 https://doi.org/10.3389/fnut.2020.597600 kostenfrei https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b kostenfrei https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full kostenfrei https://doaj.org/toc/2296-861X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
allfieldsSound	10.3389/fnut.2020.597600 doi (DE-627)DOAJ016975286 (DE-599)DOAJ62b71c0abfba4d098c77a00d6ad3a82b DE-627 ger DE-627 rakwb eng TX341-641 Daan L. de Frel verfasserin aut The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2. obesity diet COVID-19 lifestyle immune system Nutrition. Foods and food supply Douwe E. Atsma verfasserin aut Hanno Pijl verfasserin aut Jacob C. Seidell verfasserin aut Pieter J. M. Leenen verfasserin aut Willem A. Dik verfasserin aut Willem A. Dik verfasserin aut Elisabeth F. C. van Rossum verfasserin aut Elisabeth F. C. van Rossum verfasserin aut In Frontiers in Nutrition Frontiers Media S.A., 2014 7(2020) (DE-627)790231158 (DE-600)2776676-7 2296861X nnns volume:7 year:2020 https://doi.org/10.3389/fnut.2020.597600 kostenfrei https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b kostenfrei https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full kostenfrei https://doaj.org/toc/2296-861X Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4367 GBV_ILN_4700 AR 7 2020
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callnumber-first	T - Technology
author	Daan L. de Frel
spellingShingle	Daan L. de Frel misc TX341-641 misc obesity misc diet misc COVID-19 misc lifestyle misc immune system misc Nutrition. Foods and food supply The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19
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topic_title	TX341-641 The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19 obesity diet COVID-19 lifestyle immune system
topic	misc TX341-641 misc obesity misc diet misc COVID-19 misc lifestyle misc immune system misc Nutrition. Foods and food supply
topic_unstemmed	misc TX341-641 misc obesity misc diet misc COVID-19 misc lifestyle misc immune system misc Nutrition. Foods and food supply
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title	The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19
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title_full	The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19
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author_browse	Daan L. de Frel Douwe E. Atsma Hanno Pijl Jacob C. Seidell Pieter J. M. Leenen Willem A. Dik Elisabeth F. C. van Rossum
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title_sort	impact of obesity and lifestyle on the immune system and susceptibility to infections such as covid-19
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title_auth	The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19
abstract	Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2.
abstractGer	Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2.
abstract_unstemmed	Background: COVID-19 is a global challenge to healthcare. Obesity is common in patients with COVID-19 and seems to aggravate disease prognosis. In this review we explore the link between obesity, chronic disease, lifestyle factors and the immune system, and propose societal interventions to enhance global immunity.Search Strategy and Selection Criteria: We performed three literature searches using the keywords (1) coronavirus AND comorbidities, (2) comorbidities AND immune system, and (3) lifestyle factors AND immune system. Results were screened for relevance by the main author and a total of 215 articles were thoroughly analyzed.Results: The relationship between obesity and unfavorable COVID-19 prognosis is discussed in light of the impact of chronic disease and lifestyle on the immune system. Several modifiable lifestyle factors render us susceptible to viral infections. In this context, we make a case for fostering a healthy lifestyle on a global scale.Conclusions: Obesity, additional chronic disease and an unhealthy lifestyle interactively impair immune function and increase the risk of severe infectious disease. In adverse metabolic and endocrine conditions, the immune system is geared toward inflammation. Collective effort is needed to ameliorate modifiable risk factors for obesity and chronic disease on a global scale and increase resistance to viruses like SARS-CoV-2.
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title_short	The Impact of Obesity and Lifestyle on the Immune System and Susceptibility to Infections Such as COVID-19
url	https://doi.org/10.3389/fnut.2020.597600 https://doaj.org/article/62b71c0abfba4d098c77a00d6ad3a82b https://www.frontiersin.org/articles/10.3389/fnut.2020.597600/full https://doaj.org/toc/2296-861X
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author2	Douwe E. Atsma Hanno Pijl Jacob C. Seidell Pieter J. M. Leenen Willem A. Dik Elisabeth F. C. van Rossum
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up_date	2024-07-03T23:49:13.219Z
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