RESEARCH ARTICLE


A Negative History of Epidemiologic and Demographic Factors Associated with High Numbers of Covid-19 Deaths



Mourad Errasfa1, *
1 Department of Pharmacology, Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco


Article Metrics

CrossRef Citations:
0
Total Statistics:

Full-Text HTML Views: 388
Abstract HTML Views: 48
PDF Downloads: 54
ePub Downloads: 33
Total Views/Downloads: 523
Unique Statistics:

Full-Text HTML Views: 283
Abstract HTML Views: 42
PDF Downloads: 47
ePub Downloads: 28
Total Views/Downloads: 400



Creative Commons License
© 2022 Mourad Errasfa et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Pharmacology, Laboratory of Epidemiology and Research in Health Sciences, Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco; Tel: +212665281429; E-mail: mourad.errasfa@usmba.ac.ma


Abstract

Background:

Substantial differences between countries have been observed in terms of Covid-19 death tolls during the past two years. It is of interest to find out how the epidemiologic and/or demographic history of the population may have had a role in the high prevalence of the Covid-19 in some countries.

Objective:

This observational study aimed to investigate possible relations between Covid-19 death numbers in 39 countries and the pre-pandemic history of epidemiologic and demographic conditions.

Methods:

We sought the Covid-19 death toll in 39 countries in Europe, America, Africa, and Asia. Records (2019) of epidemiologic (Cancer, Alzheimer's disease) and demographic (natality, mortality, and fertility rates, percentage of people aged 65 and over) parameters, as well as data on alcohol intake per capita, were retrieved from official web pages. Data were analysed by simple linear or polynomial regression by means of Microsoft Excell software (2016).

Results:

When Covid-19 death numbers were plotted against the geographic latitude of each country, an inverted bell-shaped curve was obtained for both the first and second years (coefficient of determination R2=0.38) of the pandemic. In a similar manner, inverted bell-shaped curves were obtained when latitudes were plotted against the scores of cancer plus Alzheimer's disease (R2 = 0,65,), the percentage of advanced age (R2 = 0,52,), and the alcohol intake level (R2 = 0,64,). Covid-19 death numbers were positively correlated to the scores of cancer plus Alzheimer's disease (R2= 0.41, P= 1.61x10-5), advanced age (R2= 0.38, P= 4.09x10-5), and alcohol intake (R2= 0.48, P= 1.55x10-6). Instead, bell-shaped curves were obtained when latitudes were plotted against the birth rate/mortality rate ratio (R2 = 0,51) and the fertility rate (R2 = 0,33). In addition, Covid-19 deaths were negatively correlated with the birth rate/mortality rate ratio (R2= 0.67) and fertility rate (R2= 0.50).

Conclusion:

The results show that the 39 countries in both hemispheres in this study have different patterns of epidemiologic and demographic factors, and that the negative history of epidemiologic and demographic factors of the northern hemisphere countries as well as their high alcohol intake were very correlated with their Covid-19 death tolls. Hence, also nutritional habits may have had a role in the general health status of people in regard to their immunity against the coronavirus.

Keywords: Covid-19, Coronavirus, SARS-CoV-2, Cancer, Alzheimer’s disease, Alcohol, Nutrition.



1. INTRODUCTION

The Covid-19 pandemic was declared two years ago following high death tolls caused by SARS-CoV-2 infection around the world [1]. The virus and its target human cell receptor ACE-2 were identified [2, 3]. The understanding of the pathophysiology of Covid-19 [4-8] has allowed rational therapeutic management of the disease. For inflammatory conditions (cytokine storms), infections, and microcoagulations, patients were primarily treated with anti-inflammatory corticoids, antibiotics, and blood thinners [9, 10]. Vitamins (vitamin C, vitamin D), minerals (zinc and magnesium) and probiotics/prebiotics products were used as well to boost the immune system [11-13]. High scores of mortality were significantly associated with several risk factors, such as advanced age, overweight, cardiovascular and neurovascular diseases, chronic renal failure, diabetes, and cancer [14-16].

The large differences in Covid-19 mortality between countries led to questions regarding the possible causes. Africa and Asia have suffered less Covid-19 incidence and mortality [17]. Many researchers have hypothesized that Covid-19 prevalence is influenced by the immune status of an individual [18, 19]. On the other hand, alcohol consumption is known to be associated with several diseases, such as cancer [20-22]. Hence, nutritional habits may have key relevance in the course of a disease. For instance, a significant difference can be found in the nutritional habits between African countries and occidental countries, which certainly may affect the composition of intestinal microbiota, and consequently, part of the immune capacity of people. The purpose of this observational study was to examine Covid-19 deaths in 39 countries after two years of the pandemic to see if any specific epidemiologic or demographic factors could explain the differences in Covid-19 prevalence.

2. MATERIALS AND METHODS

We obtained Covid-19 death numbers from official web pages that follow Covid-19 mortality around the world [23, 24]. On the other hand, epidemiologic data [25], demographic data [26], and alcohol intake per capita [27] corresponding to 2019 were obtained from officially published documents. The data, correlation parameters, linear and polynomial regression, and figures were processed and analyzed by the Microsoft Office Excel software (2016).

The cancer score was estimated as the number of cancer cases reported in the table of ten most common causes of death in each country [25]. The Alzheimer's disease score was estimated as ‘11 minus the ranking order of Alzheimer's disease among the 10 causes of death in each country’ [25]. If Alzheimer's disease was not listed, the score was ‘0’. The advanced age score was estimated as the percentage of people aged 65 years and over. The alcohol intake score was expressed as liters/capita for people aged 15 years and over [27]. The data and records were carried out according to the STROBE guidelines [28].

3. RESULTS

We checked the geographic (latitude and longitude) coordinates of 39 countries, distributed as follows: America (the United States and Mexico), South America (Brazil, Colombia, Argentina, and Chile), Europe (France, Italy, Spain, Germany, Portugal, United Kingdom, Estonia, Lithuania, Croacia, Serbia, Poland, Romania, North Macedonia, Latvia, and Ukraine), and Africa (Morocco, Argelia, Mauritania, Tunisia, Egypt, Sudan, Congo, and Senegal). The population of the above countries is a sample of 3525 million people, which represents 44.43% of the total world population. 32 of the above countries are located in the northern hemisphere, where most (about 90%) of the world's population lives.

When the geographic latitude of each country was plotted against the Covid-19 death numbers, the polynomial regression analysis generated inverted bell-shaped curves for both the first and second year (R2= 0.38) of the pandemic (Fig. 1). Higher death rates were recorded at higher geographic latitudes in both hemispheres, like in European countries. Instead, lower death rates were recorded in countries located near the equator or those located at lower latitudes, like many African countries. The geographic longitude did not have any correlation with climate nor with other factors of the study.

Fig. (1). A Polynomial regression analysis of the geographical latitudes and the Covid-19 death numbers in the 39 countries of the study.

Fig. (2). The polynomial regression analysis of the geographic latitude levels plotted respectively against the levels of (cancer score + Alzheimer's disease score) (A), the advanced aged score (B) and the alcohol (liter) intake per capita in 2019 (C) in the 39 countries of the study.

Fig. (3). Linear regression analysis of Covid-19 death numbers and, respectively, the levels of (cancer score + Alzheimer's disease score) (panel A), the advanced aged score (panel B) and the alcohol intake per capita in 2019 (panel C).

In a similar manner, inverted bell-shaped curves were obtained when the geographic latitudes were plotted respectively against the scores of cancer plus Alzheimer's disease (R2 = 0,65) (Fig. 2 panel A), the percentage of advanced age (R2 = 0,52) (Fig. 2 panel B) and the alcohol intake level (R2 = 0,64) (Fig. 2 panel C). Interestingly, Covid-19 death numbers significantly positively correlated to the scores of cancer plus Alzheimer’s disease (R2= 0.41, P= 0.61x10-5), advanced age (R2= 0.38, P= 4.09x10-5) and alcohol intake (R2= 0.48, P= 1.55x10-6) (Fig. 3, panels A-C), respectively. Instead, bell-shaped curves were obtained when the geographic latitudes were respectively plotted against the birth rate/mortality rate ratio (R2 = 0,51) (Fig. 4, panel A) and the fertility rate (R2 = 0,33) (Fig. 4, panel B), with the lower values being recorded in countries located at higher latitudes, like in European countries. Interestingly, Covid-19 deaths significantly and highly negatively correlated to the birth rate/mortality rate ratio (R2 = 0,67, P= 3.32x10-10) and the fertility rate (R2 = 0,50, P= 6.78x10-7) (Fig. 4, panels C, D).

In an attempt to model the relationship between the epidemiologic and demographic history of the population of the 39 countries included in the study, along with both their geographic latitude and their Covid-19 deaths, we aimed to develop a global parameter that takes into account several epidemiologic and demographic factors of the present study. The parameter is called the general immune capacity (GIC) score, which we have expressed as follows:

GIC = (birth rate/mortality rate) x fertility rate / (cancer sore + Alzheimer's disease score) + (% age 65 years and over) + (liters of alcohol intake per capita per year).

Fig. (4). The polynomial regression expression of the geographic latitude levels is plotted against the (birth rate/mortality rate) ratio (panel A) and fertility rate (panel B), respectively. Linear regression of the Covid-19 death numbers and the birth rate/mortality rate ratio (panel C) and the fertility rate (panel D) in the 39 countries of the study.

Fig. (5). The polynomial regression analysis (panel A) of the geographical latitudes versus the general immune capacity (expressed in log units), and the linear regression analysis (panel B) of the general immune capacity (GIC) versus the Covid-19 deaths in the 39 countries of the study.

When the geographic latitudes were plotted against the GIC scores (expressed in logarithm units) of each country, the polynomial analysis generated a bell-shaped curve (R2 = 0.59) (Fig. 5, panel A), and the GIC values were found to highly correlate (R2= 0.67, P= 2.66x10-10) to the Covid-19 deaths (Fig. 5, panel B).

4. DISCUSSION

The low COVID-19 prevalence in northern and central Africa compared to Europe during the pandemic's first two years was of particular interest. Questions have been raised about the reasons behind such significant differences. In the present observational study, we have analysed epidemiologic and demographic history as well as records of alcohol intake in 39 representative countries from around the world. Indeed, the population of the countries in this study represented more than 44% of the total world’s population. In the present observational study, we have shown that some demographic factors vary from one country to another, and they are highly correlated with geographic latitude. Indeed, the birth rate/mortality rate ratio and the fertility rate are higher, for example, in African countries located around the equator or at low and median latitudes, such as Senegal, Mauritania, Morocco, and Egypt. Instead, countries located at higher latitudes, like those of Europe and America, have lower trends in birth rate/mortality rate ratio and fertility rate. On the other hand, the percentage of people aged 65 years and over is higher in countries of higher latitudes, mainly those of the northern hemisphere, in contrast to countries of lower latitudes, such as those located in Africa. Likewise, the above data point to the low prevalence of Covid-19 disease in countries that have a high percentage of young people, and most of them are located mainly at the lower and median geographic latitudes of both hemispheres. In contrast to northern hemisphere countries at higher latitudes, those at lower and median latitudes have lower scores for both cancer and Alzheimer's disease, and they also have low levels of alcohol consumption. The above results clearly indicate that the negative patterns of the epidemiologic and demographic history, as well as the consumption habits of excessive alcohol intake, all have a close positive correlation and relationship with the high death tolls in many countries, regardless of the vaccination share of the populations. In addition, our score of the general immune capacity (GIC), similarly to many demographic, epidemiologic, and alcohol intake factors, is very much correlated with both the geographic latitudes and the Covid-19 death patterns. The GIC score developed in this study could be a genuine human-related epidemiologic, demographic, and consumption habit factor for the estimation of the vulnerability of a given population against either Covid-19 or other non-communicable diseases. The immune capacity of an individual is related to nutritional habits. It is known that in Africa, many food recipes are based on natural plants and food products, such as fruits, seeds, dry fruits and tea [29-35], breastfeeding habits [36-39] and other healthy milk products [40-59], as well as many plant oils, like olive and argan oils, that have proven to be healthy against cardiovascular diseases and many chronic health conditions [60-74], and are consumed in traditional societies. The above food items are composed of hundreds of molecular ingredients that are key elements for healthy nutritional habits that contribute to the body’s anti-oxidant status and the general immune capacity. All of the above nutritional parameters are of high value for boosting the immune system, and might represent a relevant parameter against chronic and infectious diseases.

The strength of our study is the significant statistical result that exhibits a possible link between the burden of chronic diseases, such as cancer and Alzheimer's disease, the rate of the elderly and alcohol consumption in a country with the level of covid-19 deaths, as well as the inverse correlation between the birth rate in a country and the number of covid-19 deaths. These parameters have pointed to Western countries as a privileged target for the coronavirus. The weakness of our study is the lack of more precise data on the exact demographic and epidemiological characteristics of the people counted as having died from the coronavirus among the populations of the 39 countries analyzed in our study.

CONCLUSION

The data from the present study support the hypothesis that the negative epidemiologic and demographic history of countries of higher latitudes may play a role in the high COVID-19 death tolls in many European countries. In the above countries, heavy drinkers may also have had a bad outcome from coronavirus infection.

LIST OF ABBREVIATIONS

GIC = General Immune Capacity
AD = Alzheimer's Disease

ETHICS APPROVAL AND CONSENT TO PARTICIPATE

Not applicable.

HUMAN AND ANIMAL RIGHTS

Not applicable.

CONSENT FOR PUBLICATION

Not applicable.

STANDARDS OF REPORTING

STROBE guideline has been followed.

AVAILABILITY OF DATA AND MATERIALS

Covid-19 death tolls during the past two years were investigated in 39 countries in regard to epidemiologic and demographic factors.

The data will be avalable at, https://dataverse.harvard.edu/ dataset.xhtml?persistentId=doi:10.7910/DVN/XWOREU

FUNDING

None.

CONFLICT OF INTEREST

The author declares no conflict of interest, financial or otherwise.

ACKNOWLEDGEMENTS

Declared none.

REFERENCES

[1] Chan JFW, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: A study of a family cluster. Lancet 2020; 395(10223): 514-23.
[2] Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature 2020; 579(7798): 265-9.
[3] Walls AC, Park YJ, Tortorici A, Wall A, McGuire AT, Veesler D. Structure, function, and antigenicity of the SARSCoV- 2 spike glycoprotein. Cell 2020; 8674(20): 30262-2.
[4] Verity R, Okell LC, Dorigatti I, et al. Estimates of the severity of coronavirus disease 2019: A model-based analysis. Lancet Infect Dis 2020; 20(6): 669-77.
[5] Cui S, Chen S, Li X, Liu S, Wang F. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost 2020; 18(6): 1421-4.
[6] Dhar D, Mohanty A. Gut microbiota and Covid-19- possible link and implications. Virus Res 2020; 285: 198018.
[7] Zuo T, Zhang F, Lui GCY, et al. Alterations in gut microbiota of patients with COVID-19 during time of hospitalization. Gastroenterology 2020; 159(3): 944-55.
[8] Ricardo J, Ari Manuel J. COVID-19 cytokine storm: The interplay between inflammation and coagulation. Lancet Respir Med 2020; (20): 30216-2.
[9] Tobaiqy M, Qashqary M, Al-Dahery S, et al. Therapeutic management of patients with COVID-19: A systematic review. Infect Prev Pract 2020; 2(3): 100061.
[10] Errasfa M. Blood hemostasis dysfunction and inflammation in covid-19 patients: Viral and host active molecules as therapeutic targets. Open Toxicol J 2021; 7(1): 1-7.
[11] Tsai YL, Lin TL, Chang CJ, et al. Probiotics, prebiotics and amelioration of diseases. J Biomed Sci 2019; 26(1): 3.
[12] Errasfa M. Magnesium therapeutic potential against Covid-19: Could it be an “All-in-one” therapy? Magnes Res 2021; 34(1): 32-4.
[13] Mourad E. Milk oligosaccharides and lectins as candidates for clinical trials against covid-19. Curr Nutr Food Sci 2021; 17(3): 246-8.
[14] Semenzato L, Botton J, Drouin J, et al. Chronic diseases, health conditions and risk of COVID-19-related hospitalization and in-hospital mortality during the first wave of the epidemic in France: A cohort study of 66 million people. Lancet Reg Health Eur 2021; 8: 100158.
[15] Carmona-Pírez J, Gimeno-Miguel A, Bliek-Bueno K, et al. Identifying multimorbidity profiles associated with COVID-19 severity in chronic patients using network analysis in the PRECOVID Study. Sci Rep 2022; 12(1): 2831.
[16] Chung GKK, Chan SM, Chan YH, et al. Differential impacts of multimorbidity on covid-19 severity across the socioeconomic ladder in Hong Kong: A syndemic perspective. Int J Environ Res Public Health 2021; 18(15): 8168.
[17] Mariam SH. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic: Are Africa’s prevalence and mortality rates relatively low? Adv Virol 2022; 2022: 1-11.
[18] Tso FY, Lidenge SJ, Peña PB, et al. High prevalence of pre-existing serological cross-reactivity against SARS-CoV-2 in sub-Sahara Africa. Int J Infect Dis 2020; 102: 577-83.
[19] Iesa MAM, Osman MEM, Hassan MA, et al. SARS-CoV-2 and Plasmodium falciparum common immunodominant regions may explain low COVID-19 incidence in the malaria-endemic belt. New Microbes New Infect 2020; 38: 100817.
[20] Shield KD, Parry C, Rehm J. Chronic diseases and conditions related to alcohol use. Alcohol Res 2013; 35(2): 155-73.
[21] Rehm J. The risks associated with alcohol use and alcoholism. Alcohol Res Health 2011; 34(2): 135-43.
[22] Rumgay H, Shield K, Charvat H, et al. Global burden of cancer in 2020 attributable to alcohol consumption: A population-based study. Lancet Oncol 2021; 22(8): 1071-80.
[23] Our world in data. coronavirus pandemic (COVID-19). 2020 Available from: https://ourworldindata.org/coronavirus
[24] Jon Hopkins University (JHU). COVID-19 Dashboard, by the Centre for the Systems Science and Engineering (CSSE). 2022. Available from: https://coronavirus.jhu.edu/map.html
[25] El INE. buscador. Available from: https://www.healthdata.org/france 40https://www.ine.es/buscar/searchResults.do?Menu_botonBuscador=&searchType=DEF_SEARCH&startat=0&L=0&searchString=poblacion
[26] WorldData.info. United states, geography. 1776. Available from: https://www.worlddata.info/america/usa/index.php Available from: www.statista.com/statistics/457822/share-of-old-age-population-in-the-total-us-population/
[27] Alcohol consumption by country. Available from: https://worldpopulationreview.com/country-rankings/alcohol-consumption-by-country
[28] Cuschieri S. The STROBE guidelines. Saudi J Anaesth 2019; 13(5 (supp 1)): 31.
[29] Bernacchia R, Preti R, Vinci G. Chemical composition and health benefits of flaxseed. Austin J Nutr Food Sci 2014; 2(8): 1045.
[30] Popa V-M, Gruia A, Raba D, et al. Fatty acids composition and oil characteristics of linseed (Linum Usitatissimum L.) from Romania. J Agroaliment Proc Techno 2012; 18(2): 136-40.
[31] Rodriguez-Leyva D, Weighell W, Edel AL, et al. Potent antihypertensive action of dietary flaxseed in hypertensive patients. Hypertension 2013; 62(6): 1081-9.
[32] Franklyn De Silva S. Pharmaceuticals 2019; 12: 68.
[33] Bhat KV, Kumari R, Pathak N, Rai AK. Value addition in sesame: A perspective on bioactive components for enhancing utility and profitability. Pharmacogn Rev 2014; 8(16): 147-55.
[34] Cabrera C, Artacho R, Giménez R. Beneficial effects of green tea--a review. J Am Coll Nutr 2006; 25(2): 79-99.
[35] Chacko SM, Thambi PT, Kuttan R, Nishigaki I. Beneficial effects of green tea: A literature review. Chin Med 2010; 5(1): 13.
[36] Ruhaak LR, Lebrilla CB. Analysis and role of oligosaccharides in milk. BMB Rep 2012; 45(8): 442-51.
[37] Yang B, Chuang H, Chen RF. Protection from viral infections by human milk oligosaccharides: Direct blockade and indirect modulation of intestinal ecology and immune reactions. Open Glycosci 2012; 5(1): 19-25.
[38] Hosea Blewett HJ, Cicalo MC, Holland CD, Field CJ. The immunological components of human milk. Adv Food Nutr Res 2008; 54: 45-80.
[39] Giansanti F, Panella G, Leboffe L, Antonini G. Lactoferrin from milk: Nutraceutical and pharmacological properties. Pharmaceuticals 2016; 9(4): 61.
[40] Kula J, Tegegne D. Chemical composition and medicinal values of camel milk. IJRSB 2016; 4(4): 13-25.
[41] EL-Fakharany EM, Sánchez L, Al-Mehdar HA, Redwan EM. Effectiveness of human, camel, bovine and sheep lactoferrin on the hepatitis C virus cellular infectivity: Comparison study. Virol J 2013; 10(1): 199.
[42] Weinberg E. Antibiotic properties and applications of lactoferrin. Curr Pharm Des 2007; 13(8): 801-11.
[43] Vega-Bautista A, de la Garza M, Carrero JC, Campos-Rodríguez R, Godínez-Victoria M, Drago-Serrano ME. The impact of lactoferrin on the growth of intestinal inhabitant bacteria. Int J Mol Sci 2019; 20(19): 4707.
[44] Singh R, Mal G, Kumar D, Patil NV, Pathak KML. Camel milk: An important natural adjuvant. Agric Res 2017; 6(4): 327-40.
[45] Al-Omari MM, Abed Alkarem Abu Alhaija RBA-G, Zoubi HA, Al-Qaoud KM, Al-Qaoud KM. Camel milk whey inhibits inflammatory colorectal cancer development via down regulation of pro-inflammatory cytokines in induced AOM/DSS mouse model. Emir J Food Agric 2019; 31(4): 256-62.
[46] Krishnankutty R, Iskandarani A, Therachiyil L, et al. Anticancer activity of camel milk via induction of autophagic death in human colorectal and breast cancer cells. Asian Pac J Cancer Prev 2018; 19(12): 3501-9.
[47] Badawy AA, El-Magd MA, AlSadrah SA. Therapeutic effect of camel milk and its exosomes on MCF7 cells in vitro and in vivo. Integr Cancer Ther 2018; 17(4): 1235-46.
[48] El Fakharany EM, Abd El Baky N, Linjawi MH, et al. Influence of camel milk on the hepatitis C virus burden of infected patients. Exp Ther Med 2017; 13: 1313-20.
[49] El Agamy ESI, Ruppanner R, Ismail A, Champagne CP, Assaf R. Antibacterial and antiviral activity of camel milk protective proteins. J Dairy Res 1992; 59(2): 169-75.
[50] Agrawal RP, Jain S, Shah S, Chopra A, Agarwal V. Effect of camel milk on glycemic control and insulin requirement in patients with type 1 diabetes: 2-years randomized controlled trial. Eur J Clin Nutr 2011; 65(9): 1048-52.
[51] Mansour AA, Nassan MA, saleh OM, Soliman MM. Protective effect of camel milk as anti-diabetic supplement: Biochemical, molecular and immunohistochemical study. Afr J Tradit Complement Altern Med 2017; 14(4): 108-19.
[52] Arab HH, Salama SA, Abdelghany TM, et al. Camel milk attenuates rheumatoid arthritis via inhibition of mitogen activated protein kinase pathway. Cell Physiol Biochem 2017; 43(2): 540-52.
[53] Wang Z, Zhang W, Wang B, Zhang F, Shao Y. Influence of bactrian camel milk on the gut microbiota. J Dairy Sci 2018; 101(7): 5758-69.
[54] Etzold S, Bode L. Glycan-dependent viral infection in infants and the role of human milk oligosaccharides. Curr Opin Virol 2014; 7: 101-7.
[55] Morrow AL, Ruiz-Palacios GM, Jiang X, Newburg DS. Human-milk glycans that inhibit pathogen binding protect breast-feeding infants against infectious diarrhea. J Nutr 2005; 135(5): 1304-7.
[56] Craft KM, Townsend SD. The human milk glycome as a defense against infectious diseases: Rationale, challenges, and opportunities. ACS Infect Dis 2018; 4(2): 77-83.
[57] Wiciński M, Sawicka E, Gębalski J, Kubiak K, Malinowski B. Human milk oligosaccharides: Health benefits, potential applications in infant formulas, and pharmacology. Nutrients 2020; 12(1): 266.
[58] Tandon D, Haque MM, Gote M, et al. A prospective randomized, double-blind, placebo-controlled, dose-response relationship study to investigate efficacy of fructo-oligosaccharides (FOS) on human gut microflora. Sci Rep 2019; 9(1): 5473.
[59] Morozov V, Hansman G, Hanisch FG, Schroten H, Kunz C. Human milk oligosaccharides as promising antivirals. Mol Nutr Food Res 2018; 62(6): 1700679.
[60] Buckland G, Gonzalez CA. The role of olive oil in disease prevention: A focus on the recent epidemiological evidence from cohort studies and dietary intervention trials. Br J Nutr 2015; 113(S2): S94-S101.
[61] Reboredo-Rodríguez P, Varela-López A, Forbes-Hernández TY, et al. Phenolic compounds isolated from olive oil as nutraceutical tools for the prevention and management of cancer and cardiovascular diseases. Int J Mol Sci 2018; 19(8): 2305.
[62] Calahorra J, Shenk J, Wielenga VH, et al. Hydroxytyrosol, the major phenolic compound of olive oil, as an acute therapeutic strategy after ischemic stroke. Nutrients 2019; 11(10): 2430.
[63] Khallouki F, Younos C, Soulimani R, et al. Consumption of argan oil (Morocco) with its unique profile of fatty acids, tocopherols, squalene, sterols and phenolic compounds should confer valuable cancer chemopreventive effects. Eur J Cancer Prev 2003; 12(1): 67-75.
[64] Marfil R, Giménez R, Martínez O, et al. Determination of polyphenols, tocopherols, and antioxidant capacity in virgin argan oil (Argania spinosa, Skeels). Eur J Lipid Sci Tech 2011; 113(7): 886-93.
[65] Rueda A, Seiquer I, Olalla M, Giménez R, Lara L, Cabrera-Vique C. Characterization of fatty acid profile of argan oil and other edible vegetable oils by gas chromatography and discriminant analysis. J Chem 2014; 2014: 8.
[66] Venegas C, Cabrera-Vique C, García-Corzo L, Escames G, Acuña-Castroviejo D, López LC. Determination of coenzyme Q10, coenzyme Q9, and melatonin contents in virgin argan oils: Comparison with other edible vegetable oils. J Agric Food Chem 2011; 59(22): 12102-8.
[67] Bahrampour Juybari K, Pourhanifeh MH, Hosseinzadeh A, Hemati K, Mehrzadi S. Melatonin potentials against viral infections including COVID-19: Current evidence and new findings. Virus Res 2020; 287: 198108.
[68] Ould Mohamedou MM, Tacha A, El Messal M, El Kebbaj MS, Chraibi A, Adlouni A. The consumption of argan oil induces a lipid-lowering effect in dyslipidemic patients. Med J Nutrition Metab 2012; 5(2): 143-7.
[69] Sour S, Belarbi M, Khaldi D, et al. Argan oil improves surrogate markers of CVD in humans. Br J Nutr 2012; 107(12): 1800-5.
[70] Haimeur A, Messaouri H, Ulmann L, et al. Argan oil prevents prothrombotic complications by lowering lipid levels and platelet aggregation, enhancing oxidative status in dyslipidemic patients from the area of Rabat (Morocco). Lipids Health Dis 2013; 12(1): 107.
[71] Batta FZ, Sqalli HT, Alaoui SK, et al. Hemodialysis-associated dyslipidemia: Effect of virgin argan oil consumption. J Int Res Med Pharm Sci 2016; 9(3): 139-45.
[72] Eljaoudi R, Elkabbaj D, Bahadi A, Ibrahimi A, Benyahia M, Errasfa M. Consumption of Argan Oil Improves Anti-Oxidant and Lipid Status in Hemodialysis Patients. Phytother Res 2015; 29(10): 1595-9.
[73] Essouiri J, Harzy T, Benaicha N, Errasfa M, Abourazzak FE. Effectiveness of Argan oil on knee osteoarthritis symptoms: A randomized controlled clinical trial. Curr Rheumatol Rev 2017; 13(3): 231-5.
[74] Essouiri J, Abourazzak FE, Lazrak F, et al. Efficacy of Argan oil on metabolic syndrome in a Moroccan knee osteoarthritis population. Curr Rheumatol Rev 2018; 14(1): 84-8.