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Bousquet, J, Anto, JM, Czarlewski, W, et al; ARIA group. Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19. Allergy. 2021; 76: 735– 750. https://doi.org/10.1111/all.14549

Cabbage and fermented vegetables : from death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

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Author: Bousquet, Jean1,2,3; Anto, Josep M.4,5,6,7; Czarlewski, Wienczyslawa8,9;
Organizations: 1Charité, Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
2Department of Dermatology and Allergy, Berlin Institute of Health, Comprehensive Allergy Center, Berlin, Germany
3MACVIA-France and CHU, Montpellier, France
4Centre for Research in Environmental Epidemiology (CREAL), ISGlobAL, Barcelona, Spain
5IMIM (Hospital del Mar Research Institute), Barcelona, Spain
6Universitat Pompeu Fabra (UPF), Barcelona, Spain
7CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
8MASK-Air, Montpellier, France
9Medical Consulting Czarlewski, Levallois, France
10Skin and Allergy Hospital, Helsinki University Hospital, University of Helsinki, Finland
11Faculty of Sciences, GreenUPorto - Sustainable Agrifood Production Research Centre, DGAOT, University of Porto, Porto, Portugal
12Department of Advanced Biomedical Sciences, Federico II University, Napoli, Italy
13Department of Geriatrics, Montpellier University hospital and MUSE, Montpellier, France
14World Business Council for Sustainable Development (WBCSD), Geneva, Switzerland
15AgroParisTech - Paris Institute of Technology for Life, Food and Environmental Sciences, Paris, France
16Usher Institute, University of Edinburgh, Scotland, UK
17Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 6.1 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2022030321788
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2022-03-03
Description:

Abstract

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT₁R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT₁R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.

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Series: Allergy
ISSN: 0105-4538
ISSN-E: 1398-9995
ISSN-L: 0105-4538
Volume: 76
Issue: 3
Pages: 735 - 750
DOI: 10.1111/all.14549
OADOI: https://oadoi.org/10.1111/all.14549
Type of Publication: A2 Review article in a scientific journal
Field of Science: 3141 Health care science
Subjects:
Copyright information: © 2020 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. This is the peer reviewed version of the following article: Bousquet, J, Anto, JM, Czarlewski, W, et al; ARIA group. Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19. Allergy. 2021; 76: 735– 750, which has been published in final form at https://doi.org/10.1111/all.14549. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.