We are all unique. Our research programmes are helping us to harness this knowledge to help everyone achieve optimal health.

Earlier this year, researchers from King’s College London and ZOE published the results of two major research studies, in the high profile scientific journal Nature Medicine. The first showed how data from millions of users of our COVID Symptom Study app can be used to predict whether someone is likely to have COVID-19, even without a physical test. 

The second details the findings from PREDICT - the largest in-depth nutrition study in the world. Based on the most detailed large scale investigation of metabolic responses to food ever carried out  with more than 1,000 participants, most of them twins, this shows that everyone responds to food in their own way. 

Both studies show the power of large-scale data to understand how the body works on a highly personal level, whether in sickness or in health. 

While initially these seemed like very different topics, it has become increasingly clear that they fit together closely on a scientific level.

In the same way that we all respond differently to food, COVID-19 is a highly variable disease, with some people becoming seriously ill following coronavirus infection while others have mild symptoms or none at all. It’s starting to become clear that a number of different factors work together to determine our individual risk.

Our COVID Symptom Study has revealed that obesity, diabetes and poor metabolic health - all conditions related to nutrition - also increase your chances of suffering the worst effects of COVID-19, along with ethnicity and social factors like deprivation.‍

Nutrition and COVID-19: more similar than you might think‍

Though nutrition and COVID-19 research may seem unrelated at first glance, it turns out there are plenty of similarities between how people respond to food and how people respond to coronavirus:

• People respond to food and coronavirus infection in a highly personalised way.
• Many of the risk factors for severe COVID-19 are very similar to the risk factors for unhealthy responses to food (obesity, diabetes, inflammation, age, gut health and poor diet)
• One-size-fits-all advice about COVID-19 risks doesn't work, and neither does one-size-fits-all advice about nutrition.
• We’re using apps, artificial intelligence (AI) and machine learning to gather data and develop algorithms to understand individual risk and predict how you, as an individual, are likely to respond to COVID-19. In the same way we’re developing algorithms that can predict how you will respond to different foods, based on data from our PREDICT study.
  

One of the most surprising results from PREDICT was that even identical twins, who share 100% of their genes, can have very different responses to exactly the same meals. We also discovered that ‘dietary inflammation’ varies dramatically among healthy adults. We use this term to capture the complex chain of unhealthy metabolic effects that can be triggered in the hours after we eat. Repeated dietary inflammation over months and years can lead to weight gain and increased risk of developing chronic diseases including type 2 diabetes (T2D) and cardiovascular disease (CVD).

Coming from the other direction, it looks like unhealthy metabolic responses, diabetes and poor blood sugar control are risk factors for COVID-19 - a disease that can kill through  an excessive inflammatory response of the patient’s own immune system (the “cytokine storm”). 

There’s one more important factor here too, which is the role of the billions of bacteria in our guts, known collectively as the microbiome, which can be altered by what we eat and plays a significant role in determining how we respond to food.

Although we don’t yet have firm data on whether the microbiome influences individual COVID-19 risk, we do know that it plays an important role in immunity and immune responses, so we believe it’s likely that there’s a connection here too.

Using smart data science to understand how people work - in sickness and in health

The global coronavirus pandemic has focused all our minds on health. Whether we’ve been unlucky enough to be infected with the virus or not, now is a good time to think about moving towards a healthier future. 

We want to  better understand how our nutritional responses, which are linked to both obesity and diabetes, might affect the risk of COVID-19 infection and severity so that we can help people to reduce these risks in future and protect their health.

We will continue to investigate the links between COVID-19 and nutrition, and will share our insights with you through our blog.

For example, we recently released a set of questions about weight, diet, snacking, alcohol and activity into the COVID Symptom Study app, as well as specific questions for people with diabetes. 

We have more detailed nutritional questions in the form of a food frequency questionnaire (FFQ) that will be coming to the app shortly, which we have worked together with expert nutrition scientists to develop. We aim to try, for the first time, to understand the link between food and COVID symptoms, so please download the app to get involved and start logging your health today. If you want to know more about our PREDICT studies and approach to nutritional research, just head over here.

Find out more:

• COVID-19: underlying metabolic health in the spotlight – The Lancet Diabetes and Endocrinology
• Importance of metabolic health in the era of COVID-19 – Metabolism
• Real-time tracking of self-reported symptoms to predict potential COVID-19 – Nature Medicine 
• Obesity and impaired metabolic health in patients with COVID-19 – Nature Reviews Endocrinology 
• Detecting COVID-19 using AI – COVID Symptom Study 
• Boris Johnson to launch war on fat after coronavirus scare – The Times
• ‘Now in Nature Medicine’ – ZOE 
• Human postprandial responses to food and potential for precision nutrition – Nature Medicine