Association of adiposity and its changes over time with COVID-19 risk in older adults with overweight/obesity and metabolic syndrome: a longitudinal evaluation in the PREDIMED-Plus cohort

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This work was supported by a project grant from the Fundacion Francisco Soria Melguizo. The project also received support from the Community of Madrid and the European Union, through the European Regional Development Fund (ERDF)-REACT-EU resources of the Madrid Operational Program 2014-2020, in the action line of R + D + i projects in response to COVID-19, FACINGLCOVID-CM. The PREDIMED-Plus trial was supported by the official Spanish Institutions for funding scientific biomedical research, CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN) and Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), which is co-funded by the European Regional Development Fund. This study has been funded by Instituto de Salud Carlos III (ISCIII) through six coordinated FIS projects leaded by JS-S and JVi, including the follow-ing projects: PI13/00673, PI13/00492, PI13/00272, PI13/01123, PI13/00462, PI13/00233, PI13/02184, PI13/00728, PI13/01090, PI13/01056, PI14/01722, PI14/00636, PI14/00618, PI14/00696, PI14/01206, PI14/01919, PI14/00853, PI14/01374, PI14/00972, PI14/00728, PI14/01471, PI16/00473, PI16/00662, PI16/01873, PI16/01094, PI16/00501, PI16/00533, PI16/00381, PI16/00366, PI16/01522, PI16/01120, PI17/00764, PI17/01183, PI17/00855, PI17/01347, PI17/00525, PI17/01827, PI17/00532, PI17/00215, PI17/01441, PI17/00508, PI17/01732, PI17/00926, PI19/00957, PI19/00386, PI19/00309, PI19/01032, PI19/00576, PI19/00017, PI19/01226, PI19/00781, PI19/01560, PI19/01332, PI20/01802, PI20/00138, PI20/01532, PI20/00456, PI20/00339, PI20/00557, PI20/00886, PI20/01158; the Especial Action Project entitled: "Implement-acion y evaluacion de una intervencion intensiva sobre la actividad fisica Cohorte PREDIMED-Plus grant to JS-S" and co-funded by the European Union. It is also supported by the European Research Council (Advanced Research Grant 2014-2019; agreement #340918) granted to M & Aacute;M-G; the Recercaixa (number 2013ACUP00194) grant to JS-S; grants from the Consejeria de Salud de la Junta de Andalucia (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017, PROMETEO 21/2021 grants from the Generalitat Valenciana; and the SEMERGEN grant. S.G.S is a recipient of the Maria Zambrano Fellowship with funding support from the Ministry of Universities and the Recovery, Transformation and Resilience Plan, Spain. The Fellowship is "Funded by the European Union - NextGenerationEU". S.K.N. is supported by a postdoctoral fellowship from the Canadian Institutes of Health Research (CIHR, MFE-171207). JS-S was partially supported by ICREA under the ICREA Academia program. We thank CERCA Programme/Generalitat de Catalunya for institutional support. The funders had no role in study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

Analysis of institutional authors

Salas Salvadó, JorgeAuthorBabio Sánchez, Nancy ElviraAuthorShyam SAuthorGarcía-Gavilán JfAuthorPaz-Graniel IAuthorNishi SkAuthor

October 16, 2023

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Association of adiposity and its changes over time with COVID-19 risk in older adults with overweight/obesity and metabolic syndrome: a longitudinal evaluation in the PREDIMED-Plus cohort

Publicated to:Bmc Medicine. 21 (1): 390-390 - 2023-10-13 21(1), DOI: 10.1186/s12916-023-03079-z

Authors: Shyam, Sangeetha; Garcia-Gavilan, Jesus Francisco; Paz-Graniel, Indira; Gaforio, Jose J; Gaforio, Jose J; Martinez-Gonzalez, Miguel angel; Corella, Dolores; Martinez, J Alfredo; Martinez, J Alfredo; Alonso-Gomez, angel M; Alonso-Gomez, angel M; Waernberg, Julia; Vioque, Jesus; Romaguera, Dora; Lopez-Miranda, Jose; Estruch, Ramon; Tinahones, Francisco J; Tinahones, Francisco J; Lapetra, Jose; Serra-Majem, J Luis; Serra-Majem, J Luis; Bueno-Cavanillas, Aurora; Tur, Josep A; Tur, Josep A; Sanchez, Vicente Martin; Pinto, Xavier; Matia-Martin, Pilar; Vidal, Josep; Vazquez, Clotilde; Daimiel, Lidia; Ros, Emilio; Fernandez-Aranda, Fernando; Nishi, Stephanie K; Nishi, Stephanie K; Garcia-Regata, Oscar; Toledo, Estefania; Asensio, Eva M; Asensio, Eva M; Castaner, Olga; Garcia-Rios, Antonio; Torres-Collado, Laura; Gomez-Gracia, Enrique; Zulet, M Angeles; Zulet, M Angeles; Ruiz, Nuria Goni; Casas, Rosa; Cano-Ibanez, Naomi; Tojal-Sierra, Lucas; Gomez-Perez, A M; Gomez-Perez, A M; Sorli, Jose V; Sorli, Jose V; Cinza-Sanjurjo, Sergio; Martin-Pelaez, Sandra; Pena-Orihuela, Patricia J; Pena-Orihuela, Patricia J; Oncina-Canovas, Alejandro; Perez-Araluce, Rafael; Zomeno, Maria Dolores; Chaplin, Alice; Delgado-Rodriguez, Miguel; Babio, Nancy; Fito, Montserrat; Salas-Salvado, Jordi

Affiliations

Bioaraba Health Research Institute, Cardiovascular, Respiratory and Metabolic Area, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, Vitoria-Gasteiz, Spain. - Author

CEI UAM CSIC, Nutrit Control Epigenome Grp, Precis Nutr & Obes Program, IMDEA Food, Madrid, Spain - Author

Centro de Investigación Biomédica en Red Fisiopatologia de la Obesidad y la Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. - Author

Centro de Investigación Biomédica en Red Fisiopatología de La Obesidad y La Nutrición (CIBEROBN), Institute of Health Carlos III, Madrid, Spain. Sangeetha.Shyam@urv.cat. - Author

CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. - Author

CIBER Diabetes y Enfermedades Metabólicas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. - Author

CS MilladoiroArea Sanitaria Santiago Compostela, Santiago De Compostela, CS, Spain - Author

Ctr Invest Biomed Red Enfermedades Cardiovasc CIB, Madrid, Spain - Author

Departamento de Ciencias de la Salud, Instituto Universitario de Investigación en Olivar y Aceites de Oliva, Universidad de Jaén, Jaén, Spain. - Author

Departamento de Ciencias Farmacéuticas y de la Salud, Faculty de Farmacia, Universidad San Pablo-CEU, CEU Universities, Boadilla del Monte, Spain. - Author

Department of Clinical Psychology, University Hospital of Bellvitge and University of Barcelona, Barcelona, Spain. - Author

Department of Endocrinology and Nutrition, Hospital Fundación Jimenez Díaz, Instituto de Investigaciones Biomédicas IISFJD, University Autonoma, Madrid, Spain. - Author

Department of Endocrinology and Nutrition, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain. - Author

Department of Endocrinology, Institut d`Investigacions Biomédiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. - Author

Department of Endocrinology, Virgen de la Victoria Hospital, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain. - Author

Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Seville, Spain. - Author

Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain. - Author

Department of Internal Medicine, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain. - Author

Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. - Author

Department of Physiology and Nutrition, University of Navarra, Pamplona, Spain. - Author

Department of Preventive Medicine and Public Health, Instituto de Investigación Sanitaria de Navarra (IdiSNA), University of Navarra, Pamplona, Spain. - Author

Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain. - Author

Department of Preventive Medicine, University of Valencia, Valencia, Spain. - Author

Distrito Sanitario Atenc Primaria Sevilla, Dept Family Med, Res Unit, Seville, Spain - Author

EpiPHAAN Research Group, School of Health Sciences, University of Málaga - Instituto de Investigación Biomédica en Málaga (IBIMA), Málaga, Spain. - Author

Gerencia Atenc Primaria, Navarra, Spain - Author

Harvard TH Chan Sch Publ Hlth, Dept Nutr, Boston, MA USA - Author

Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain. - Author

Hlth Res Inst Balearic Isl IdISBa, Palma De Mallorca, Spain - Author

Hosp Univ Bellvitge IDIBELL, Lipids & Vasc Risk Unit, Internal Med, Barcelona, Spain - Author

IMDEA Alimentac, Precis Nutr & Cardiometabol Hlth Program, Madrid, Spain - Author

Inst Hlth Carlos III, Ctr Invest Biomed Red Fisiopatol Obesi, Madrid, Spain - Author

Inst Hosp Mar Investigac Med Municipal, Unit Cardiovasc Risk & Nutr, Barcelona, Spain - Author

Inst Invest Biomed August Pi Sunyer IDIBAPS, Hosp Clin, Dept Endocrinol & Nutr, Lipid Clin, Barcelona, Spain - Author

Inst Invest Biomed Bellvitge IDIBELL, Psychoneurobiol Eating & Addict Behav Grp, Barcelona, Spain - Author

Inst Invest Biosanitaria Granada Ibs GRANADA, Granada, Spain - Author

Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Dept Endocrinol & Nutr, Madrid, Spain - Author

Inst Invest Sanitaria Pere Virgili IISPV, Reus, Spain - Author

Inst Invest Santiago Compostela IDIS, Santiago De Compostela, Spain - Author

Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metabol CIBERdem, Madrid, Spain - Author

Inst Salud Carlos III ISCIII, CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain - Author

Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. - Author

Institut d'Investigació Sanitària Pere Virgili (IISPV), Reus, Spain. Sangeetha.Shyam@urv.cat. - Author

Institut de Recerca en Nutrició i Seguretat Alimentaria (INSA-UB), University of Barcelona, Barcelona, Spain. - Author

Institute of Biomedicine (IBIOMED), University of León, León, Spain. - Author

Instituto de Investigación Sanitaria y Biomédica de Alicante, Universidad Miguel Hernández (ISABIAL-UMH), Alicante, Spain. - Author

Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain. - Author

Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge-IDIBELL, Hospitalet de Llobregat, Barcelona, Spain. - Author

Medicine and Endocrinology, UVA, Valladolid, Spain. - Author

Medicine Department, Universidad Complutense, Madrid, Spain. - Author

Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain - Author

Nutritional Control of the Epigenome Group, Precision Nutrition and Obesity Program, IMDEA Food, CEI UAM + CSIC, Madrid, Spain. - Author

Precision Nutrition and Cardiometabolic Health Program, IMDEA Alimentacion, Madrid, Spain. - Author

Psychoneurobiology of Eating and Addictive Behaviors Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain. - Author

Research Group On Community Nutrition & Oxidative Stress, University of Balearic Islands, Palma, Spain. - Author

Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & Centro Hospitalario Universitario Insular Materno Infantil (CHUIMI), Canarian Health Service, Las Palmas de Gran Canaria, Spain. - Author

Serv Navarro Salud Osasumbidea, Pamplona, Spain - Author

St Michaels Hosp, Unity Hlth Toronto, Toronto 3D Diet Digest Tract & Dis Knowledge Synt, Clin Nutr & Risk Factor Modificat Ctr, Toronto, ON, Canada - Author

Toronto 3D (Diet, Digestive Tract and Disease) Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada. - Author

Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas Municipal d'Investigació Mèdica (IMIM), Barcelona, Spain. - Author

Univ Autonoma, Inst Investigac Biomed IISFJD, Hosp Fdn Jimenez Diaz, Dept Endocrinol & Nutr, Madrid, Spain - Author

Univ Balearic Isl, Res Grp Community Nutr Oxidat Stress, Palma De Mallorca, Spain - Author

Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Hosp Clin, Dept Endocrinol, Barcelona, Spain - Author

Univ Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS, Hosp Clin, Dept Internal Med, Barcelona, Spain - Author

Univ Barcelona, Inst Recerca Nutricio Seguretat Alimentaria INSA, Barcelona, Spain - Author

Univ Basque Country UPV EHU, Araba Univ Hosp, Bioaraba Hlth Res Inst, Osakidetza Basque Hlth Serv, Vitoria, Spain - Author

Univ Complutense, Dept Med, Madrid, Spain - Author

Univ Cordoba, Reina Sofia Univ Hosp, Maimonides Biomed Res Inst Cordoba IMIBIC, Dept Internal Med, Cordoba, Spain - Author

Univ Granada, Dept Prevent Med & Publ Hlth, Granada, Spain - Author

Univ Hosp Bellvitge, Dept Clin Psychol, Barcelona, Spain - Author

Univ Jaen, Div Prevent Med, Fac Med, Jaen, Spain - Author

Univ Jaen, Inst Univ Invest Olivar & Aceites Oliva, Dept Ciencias Salud, Jaen, Spain - Author

Univ Las Palmas Gran Canaria, Res Inst Biomed & Hlth Sci IUIBS, Canarian Hlth Serv, Las Palmas Gran Canaria, Spain - Author

Univ Leon, Inst Bio Med IBIOMED, Leon, Spain - Author

Univ Malaga, Dept Prevent Med, Malaga, Spain - Author

Univ Malaga, Inst Invest Biomed Malaga IBIMA, Virgen Victoria Hosp, Dept Endocrinol, Malaga, Spain - Author

Univ Malaga, Sch Hlth Sci, EpiPHAAN Res Grp, Inst Invest Biomed Malaga (IBIMA), Malaga, Spain - Author

Univ Miguel Hernandez ISABIAL UMH, Inst Invest Sanitaria Biomed Alicante, Alicante, Spain - Author

Univ Navarra, Dept Physiol & Nutr, Pamplona, Spain - Author

Univ Navarra, Inst Invest Sanitaria Navarra IdISNA, Dept Prevent Med & Publ Hlth, Pamplona, Spain - Author

Univ Ramon Llull, Sch Hlth Sci, Barcelona, Spain - Author

Univ Rovira & Virgili, Dept Bioquim & Biotecnol, Grup Alimentacio Nutricio Desenvolupament & Salut, Unitat Nutricio Humana, Reus, Spain - Author

Univ San Pablo CEU, CEU Univ, Dept Ciencias Farmaceut Salud, Fac Farm, Boadilla Del Monte, Spain - Author

Univ Valencia, Dept Prevent Med, Valencia, Spain - Author

Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Reus, Spain. - Author

Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Grup Alimentació, Nutrició, Desenvolupament i Salut Mental, Unitat de Nutrició Humana, Reus, Spain. Sangeetha.Shyam@urv.cat. - Author

UVA, Med & Endocrinol, Valladolid, Spain - Author

Abstract

Cross-sectionally, older age and obesity are associated with increased coronavirus disease-2019 (COVID-19) risk. We assessed the longitudinal associations of baseline and changes in adiposity parameters with COVID-19 incidence in older adults at high cardiovascular risk.This analysis included 6874 men and women (aged 55-75 years) with overweight/obesity and metabolic syndrome in the PREDIMED-Plus lifestyle intervention trial for cardiovascular risk reduction. Body weight, body-mass-index (BMI), waist circumference, waist-to-height ratio (WHtR), and a body shape index (ABSI) were measured at baseline and annual follow-up visits. COVID-19 was ascertained by an independent Event Committee until 31 December 2021. Cox regression models were fitted to evaluate the risk of COVID-19 incidence based on baseline adiposity parameters measured 5-6 years before the pandemic and their changes at the visit prior to censoring.At the time of censoring, 653 incident COVID-19 cases occurred. Higher baseline body weight, BMI, waist circumference, and WHtR were associated with increased COVID-19 risk. During the follow-up, every unit increase in body weight (HRadj (95%CI): 1.01 (1.00, 1.03)) and BMI (HRadj: 1.04 (1.003, 1.08)) was associated with increased COVID-19 risk.In older adults with overweight/obesity, clinically significant weight loss may protect against COVID-19.This study is registered at the International Standard Randomized Controlled Trial (ISRCT; http://www.isrctn.com/ISRCTN89898870 ).© 2023. BioMed Central Ltd., part of Springer Nature.

Keywords

central obesitycovid-19mortalityolder adultsweight lossAdiposityAgedBody mass indexBody weightCentral obesityCovid-19FemaleHumansMaleMediterranean diet adherenceMetabolic syndromeMiddle agedObesityOlder adultsOverweightRisk factorsWaist circumferenceWeight loss

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Bmc Medicine due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 24/329, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, General & Internal. Notably, the journal is positioned above the 90th percentile.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.62, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-16, the following number of citations:

WoS: 3
Scopus: 2
Europe PMC: 2

Impact and social visibility

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Canada; Granada; United States of America.

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Shyam, Sangeetha) .

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Association of adiposity and its changes over time with COVID-19 risk in older adults with overweight/obesity and metabolic syndrome: a longitudinal evaluation in the PREDIMED-Plus cohort

Affiliations

Abstract

Keywords

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

Impact and social visibility

Leadership analysis of institutional authors