Modulation of cytokine production using immunonutrition is a relatively novel concept to improve outcomes among patients with SARS-CoV-2 infection and is now hypothesized to help manage COVID-19, however, clinical evidence is lacking. This prospective, double-blinded, randomized parallel-controlled interventional clinical trial investigated the effect of antioxidant supplements on inflammatory cytokines and disease progression in non-critically ill patients. A total of 87 hospitalized COVID-19 patients were randomized using computer-generated-randomization into the supplement group (n = 18) and the placebo group (n = 16) for 10 days. Baseline and final nutritional screening via nutrition risk screening (NRS-2002) and subjective global assessment (SGA), as well as the recording of anthropometric, clinical, biochemical, and functional parameters, were done. Serum ferritin level, cytokine storm parameters such as interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein 1(MCP-1), C-reactive protein, total leukocyte count, lymphocytic count, and neutrophil-to-lymphocyte ratio were measured. Anthropometric and clinical parameters showed nonsignificant differences between groups. The hematology profile showed improvement in lymphocyte count in the supplement group. However, levels of alkaline phosphatase, IL-6, TNF-α, and MCP-1 were significantly lower in the supplement group. In conclusion, antioxidant oral supplementation significantly reduced the cytokine storm and led to partial improvements in clinical parameters among patients with non-critical COVID-19.

Background: Inflammatory bowel diseases (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), are chronic conditions with complex etiologies that may involve dietary factors. This study investigates the association between fruit and vegetable consumption and the risk of UC and CD, focusing on gender-specific differences. Methods: A hospital-based case–control study, comprising 158 UC patients (93 men and 65 women), 245 CD patients (167 men and 78 women), and 395 controls without IBD (256 men and 139 women), was conducted in Riyadh, Saudi Arabia. Fruit and vegetable consumption data were gathered through a self-administered questionnaire distributed before diagnosis. Logistic regression analysis was applied to estimate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for UC and CD among the participants reporting the daily consumption of fruits and vegetables. Results: Among men, daily vegetable consumption was associated with higher odds of UC in the age-adjusted model [OR (95% CI): 1.78 (1.02, 3.10)], but this association became non-significant after further adjustment for body mass index, smoking, anemia, and elevated liver enzymes [OR (95% CI): 1.70 (0.91, 3.18)]. No significant associations were observed between vegetable consumption and CD. In contrast, the women who consumed vegetables every day had a non-significant inverse association with UC and a significant inverse association with CD in both the age-adjusted and multivariable-adjusted models [ORs (95% CIs): 0.44 (0.23, 0.87) and 0.41 (0.20, 0.84), respectively]. Fruit consumption was neither associated with UC nor CD in either sex. Conclusions: Daily vegetable consumption was significantly associated with decreased odds of CD among women, but not men, highlighting potential sex-specific dietary influences on IBD risk.

Background and Objectives: Diet is a potential modifiable risk factor for ulcerative colitis (UC). This study examined the associations of individual dietary components and combined dietary profiles with UC. Methods and Study Design: This case–control study included 157 patients with UC and 395 controls. Dietary consumption frequencies were converted into ordinal scores ranging from 1 to 4. Participants were additionally classified into four dietary profiles based on combined levels of risk-promoting and protective food consumption. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: Higher consumption of fast food (OR = 5.30, 95% CI: 3.65, 7.70), carbonated soft drinks (OR = 9.37, 95% CI: 5.78, 15.18), and spicy food (OR = 1.56, 95% CI: 1.21, 2.01) was positively associated with UC. Dairy consumption was inversely associated with UC (OR = 0.52, 95% CI: 0.33, 0.82). In sex-stratified analyses, vegetable consumption was inversely associated with UC among women only. Compared with participants with high risk-promoting/low protective food consumption, those with low risk-promoting/low protective food consumption (OR = 0.07, 95% CI: 0.02, 0.21) and those with low risk-promoting/high protective food consumption (OR = 0.08, 95% CI: 0.03, 0.17) had substantially lower odds of UC. The high risk-promoting/high protective food consumption was not associated with UC. Conclusions: Frequent consumption of fast food, carbonated soft drinks, and spicy food was associated with higher odds of UC, whereas dairy consumption was associated with lower odds. Lower consumption of risk-promoting foods, irrespective of protective food consumption, was associated with substantially lower odds of UC. Prospective studies are needed to confirm these associations.