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

Bousquet, Jean; Anto, Josep M; Czarlewski, Wienczyslawa; Haahtela, Tari; Fonseca, Susana C; Iaccarino, Guido; Blain, Hubert; Vidal, Alain; Sheikh, Aziz; Akdis, Cezmi A; Stute, Petra; Zuberbier, Torsten (2021). Cabbage and fermented vegetables: From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19. Allergy, 76(3), pp. 735-750. Wiley 10.1111/all.14549

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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 (AT1 R) 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 AT1 R 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.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Stute, Petra

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1398-9995

Publisher:

Wiley

Language:

English

Submitter:

Monika Zehr

Date Deposited:

08 Jan 2021 14:34

Last Modified:

04 Jan 2022 09:19

Publisher DOI:

10.1111/all.14549

PubMed ID:

32762135

Additional Information:

Collaborator ARIA group: Petra Stute

Uncontrolled Keywords:

COVID-19 Lactobacillus angiotensin-converting enzyme 2 cabbage diet fermented vegetable kimchi sulforaphane

BORIS DOI:

10.48350/151021

URI:

https://boris.unibe.ch/id/eprint/151021

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