Assessment of commitment to healthy daily habits and diets, preventive measures, and beliefs about natural products utilization during COVID-19 pandemic in certain population in Egypt and Saudi Arabia

Main Article Content


Coronavirus, COVID-19, Questionnaire , Natural food and drinks, Egypt, Saudi Arabia


<p style="text-align: justify;"><strong>Objective: </strong>The purpose of this research is to assess the commitment of participants in Saudi Arabia and Egypt towards healthy daily habits, preventive measures, healthy food habits, and beliefs about natural products as an immunostimulants during COVID-19 pandemic. <strong>Method: </strong>A cross-sectional questionnaire-based study was conducted in Saudi Arabia (mainly Riyadh and Jeddah) and Egypt (mainly Cairo). The questionnaire instrument was created based on an extensive literature review on the COVID-19 pandemic, including its spreading and transmission methods, preventive measures, healthy lifestyle, and diets that increase human immunity against viral infections and the use of natural products and drinks. The questionnaire was created by Microsoft 365&reg; office forms, participants were invited through emails and other social media. The questionnaire includes a demographic section (gender, nationality, residency country, city, age, marital status, educational level, employment status, chronic disease history, under anxiety or stress, have a temper or irritable person, were infected/currently infected and in contact to COVID-19 patient) and (23) questions arranged under five domains; Domain I daily habits (4), Domain II keeping preventive measures (4), Domain III healthy eating habits (9), Domain IV for participants currently or previously infected, or in contact with a patient (4) Domain V for assessment of participants&rsquo; beliefs towards the use of natural products to elevate immunity during COVID-19 pandemic (2), beside 4 choice questions (stimulant drinks, natural drinks, natural products, and zinc-rich food). SPSS&reg; was used to analyze the results using Student&rsquo; t-test, ANOVA, and Tukey&rsquo;s HSD tests.<strong> Result:</strong> 510 individuals with various demographic characteristics participated in the study. This study revealed that the participants belief in healthy foods, natural drinks (mainly ginger, lemon, and cinnamon), natural products (mainly honey, olive oil, and black seed), healthy habits, and preventive measures as sanitizers, social distance, and exercise. Only 13% of all participants were infected with COVID-19, although 31% of them were in contact with COVID -19 patients, about 93% were under stress, and 22% were with chronic diseases. Participants who are married, not in contact with patients and not previously infected by COVID-19 are more adhered to preventive measures while those previously or currently infected are more committed to healthy lifestyle and diet habits. Qualification level seems to make no significant difference in any domain. 78.6% of the participants beliefs in the benefits of utilizing natural products in preventing infection with corona virus or reducing the period of treatment in case of infection. About 95.7% of the infected persons had no need of hospitalization and about 50% are cured within two weeks of infection. The questionnaire revealed that Nescafe and black tea were the most used stimulant drinks among the participants, particularly the students and who were always under stress. Most of the participants agreed with the utilization of Zn-rich food, particularly Egyptians, which may help in boosting their immunity. <strong>Conclusion:</strong> Natural products selected in the present study can be used in combination with the existing clinical standards of care that have the potential to serve as prophylactic agents in populations that are at risk to develop COVID-19 infection.</p>

Abstract 2065 | PDF Downloads 657


1. World Health Organization WHO supports scientifically-proven traditional medicine; 2020.
2. Shahwar D, Raza MA, Shafiq-U, et al. An investigation of phenolic compounds from plant sources as trypsin inhibitors. Natural Product Research. 2012;26(12):1087-1093.
3. Parhiz H, Roohbakhsh A, Soltani F, et al. Antioxidant and Anti-Inflammatory Properties of the Citrus Flavonoids Hesperidin and Hesperetin: An updated review of their molecular mechanisms and experimental models: hesperidin and hesperetin as
antioxidant and anti-inflammatory agents. Phytother Res. 2015;29(3):323-331.
 4. Gopalakrishnan S, Ediga HH, Reddy SS, et al. Procyanidin-B2 enriched fraction of cinnamon acts as a proteasome inhibitor and anti-proliferative agent in human prostate cancer cells: PCB2 from cinnamon acts as a proteasome inhibitor. IUBMB Life.2018;70(5):445-457.
5. Szakiel A, Czkowski CP, Pense F, et al. Fruit cuticular waxes as a source of biologically active triterpenoids. Phytochem Rev.
6. Cazzoletti L, Zanolin ME, Spelta F, et al. Dietary fats, olive oil and respiratory diseases in Italian adults: A population‐based study. Clin Exp Allergy. 2019;49(6):799-807.
7. Li J, Ye L, Wang X, et al. Epigallocatechin gallate inhibits endotoxin-induced expression  of inflammatory cytokines in human cerebral microvascular endothelial cells. J Neuroinflammation. 2012;9:579.
8. Heinrich M, Mah J, Amirkia V. Alkaloids Used as Medicines: Structural Phytochemistry Meets Biodiversity-An Update and Forward Look. Molecules. 2021;26(7):1836.
9. Lake MA. What we know so far: COVID-19 current clinical knowledge and research. Clin Med. 2020;20(2):124-127.
10. Zhanga Y, Gengb X, Tan Y, et al. New understanding of the damage of SARS-CoV-2 infection outside therespiratory system.Biomedicine & Pharmacotherapy. 2020;127:110195.
11. Aygün İ, Kaya M, Alhajj R. Identifying side efects of commonly used drugs in the treatment of Covid 19. Scientific Reports.2020;10:21508.
12. Salath M, Althaus CL, Neher R, et al. COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation. Swiss Med Wly. 2020.
13. World Health Organization Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19); 2019. 
14. Luo H, Tang Q, Shang Y, et al. Can chinese medicine be used for prevention of corona virus disease 2019 (covid-19)? a review
of historical classics, research evidence and current prevention programs. Chin J Integr Med. 2020;26(4):243-250.
15. Khanna K, Kohli SK, Kaur R, et al. Herbal immune-boosters: Substantial warriors of pandemic Covid-19 battle. Phytomedicine.2021;85:153361.
16. Al Najrany SM, Asiri Y, Sales I, et al. The Commonly Utilized Natural Products during the COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Online Survey. IJERPH. 2021;18(9):4688.
17. World Health Organization WHO supports scientifically proven traditional medicine; 2020. 
18. Centers for Disease Control and Prevention When and How to Wash Your Hands. 2020.
19. Central Agency for Public Mobilization and Statistics. Accessed 22 September2021.
20. General Authority for Statistics. Accessed 22 September 2021.
21. Suardi C, Cazzaniga E, Graci S, et al. Link between Viral Infections, Immune System, Inflammation and Diet. IJERPH. 2021;18(5):2455.
22. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet. 2020;395(10229):1033-1034.
23. Pedersen SF, Ho YC. SARS-CoV-2: a storm is raging. Journal of Clinical Investigation. 2020;130(5):2202-2205.
24. Prompetchara E, Ketloy C, Palaga T. Immune responses in COVID-19 and potential vaccines: Lessons learned from SARS and MERS epidemic. Asian Pac J Allergy Immunol. 2020;38(1):1-9.
25. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet. 2020;395(10223):497-506.
26. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020;395(102230:507-513. 
27. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. The Lancet. 2020;395(10229):1054-1062,
28. Vatic M, von Haehling S, Ebner N. Inflammatory biomarkers of frailty. Experimental Gerontology. 2020;133:110858.
29. Kamp G, Kramer A. Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs. Clin Microbiol Rev. 2004;17(4):863-893,
30. World Health Organization Report of the WHO, Advice for the public: Coronavirus disease (COVID-19). 2022.
31. Dizdar O, Baspınar O, Kocer D, et al. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic. Nutrients. 2016;8(3):124. 
32. Aman F, Masood S. How nutrition can help to fight against COVID-19 pandemic. Pak J Med Sci. 2020;36(COVID19-S4):S121-S123.
33. Cena H, Chieppa M. Coronavirus Disease (COVID-19–SARS-CoV-2) and Nutrition: Is Infection in Italy Suggesting a Connection? Front Immunol. 2020;11:944.
34. Kumar V, Singh S, Srivastava B, et al. Green synthesis of silver nanoparticles using leaf extract of Holoptelea integrifolia and preliminary investigation of its antioxidant, anti-inflammatory, antidiabetic and antibacterial activities. Journal of EnvironmentalChemical Engineering. 2019;7:103094.
35. Fiore C, Eisenhut M, Krausse R, et al. Antiviral effects of Glycyrrhiza species. Phytother Res. 2008;22(2):141-148.
36. Chang JS, Wang KC, Yeh CF, et al. Fresh ginger (Zingiber officinale) has anti-viral activity against human respiratory syncytialvirus in human respiratory tract cell lines. Journal of Ethnopharmacology. 2013;145(1):146-151.
37. Li J, Ye L, Wang X, et al. Epigallocatechin gallate inhibits endotoxin-induced expression of inflammatory cytokines in humancerebral microvascular endothelial cells. J Neuroinflammation. 2012;9:579.
38. Horrigan LA, Kelly JP, Connor TJ. Caffeine suppresses TNF-α production via activation of the cyclic AMP/protein kinase A pathway. International Immunopharmacology. 2004;4(10-11):1409-1417.
39. Horriga L, Kelly J, Connor T. Immunomodulatory effects of caffeine: Friend or foe? Pharmacology & Therapeutics. 2006;111:877-892.
40. Erickson KL, Medina EA, Hubbard NE. Micronutrients and Innate Immunity. J Infect Dis. 2000;182:S5-S10.
41. Wang Y, Li J, Wang X, et al. Epigallocatechin-3-Gallate Enhances Hepatitis C Virus Double-Stranded RNA Intermediates-Triggered Innate Immune Responses in Hepatocytes. Sci Rep. 2016;6:21595.
42. McKechnie JL, Blish CA. The Innate Immune System: Fighting on the Front Lines or Fanning the Flames of COVID-19? Cell Host & Microbe. 2020;27(6):863-869.
43. Chowdhury P, Barooah AK. Tea Bioactive Modulate Innate Immunity: In Perception to COVID-19 Pandemic. Front Immunol.2020;11:590716.
44. Bao S, Liu MJ, Lee B, et al. Zinc modulates the innate immune response in vivo to polymicrobial sepsis through regulation of NF-kappaB. Am J Physiol Lung Cell Mol Physiol. 2010;298(6):L744-754.
45. Dizdar O, Baspınar O, Kocer D, et al. Nutritional Risk, Micronutrient Status and Clinical Outcomes: A Prospective Observational Study in an Infectious Disease Clinic. Nutrients. 2016;8(3):124.
46. Wessels I, Maywald M, Rink L. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017;9(12):1286.
47. Lee SM, McLaughlin JN, Frederick DR, et al. Metallothionein-induced zinc partitioning exacerbates hyperoxic acute lung injury.Am J Physiol Lung Cell Mol Physiol. 2013;304(5):L350-360.
48. Iddir M, Brito A, Dingeo G, et al. Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 Crisis. Nutrients. 2020;12(6):1562.
49. Grant W, Lahore H, McDonnell S, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988.
50. Mao QQ, Xu XY, Cao SY, et al. Bioactive Compounds and Bioactivities of Ginger (Zingiber officinale Roscoe). Foods. 019;8(6):185.
51. Rodrigues FA, Santos AD, de Medeiros PHQS, et al. Gingerol suppresses sepsis-induced acute kidney injury by modulating methylsulfonylmethane and dimethylamine production. Sci Rep. 2018;8(1):12154.
52. Idris NA, Yasin HM, Usman A. Voltammetric and spectroscopic determination of polyphenols and antioxidants in ginger(Zingiber officinale Roscoe). Heliyon. 2019;5(5):e01717.
53. Shariatpanahi ZV, Mokhtari M, Taleban FA, et al. Effect of enteral feeding with ginger extract in acute respiratory distress syndrome. Journal of Critical Care. 2013;28(2):217.e1-217.e6.
54. Liao YR, Leu YL, Chan YY, et al. Anti-Platelet Aggregation and Vasorelaxing Effects of the Constituents of the Rhizomes of Zingiber officinale. Molecules. 2012;17(8):8928-8937. 
55. Klimek-Szczykutowicz, Szopa. Ekiert Citrus limon (Lemon) Phenomenon—A Review of the Chemtry, Pharmacological Properties, Applications in the Modern Pharmaceutical, Food, and Cosmetics Industries, and Biotechnological Studies. Plants.2020;9(1):119.
56. Chambial S, Dwivedi S, Shukla KK, et al. Vitamin C in Disease Prevention and Cure: An Overview. Ind J Clin Biochem.
57. Hong JY, Lee CY, Lee MG, et al. Effects of dietary antioxidant vitamins on lung functions according to gender and smoking status in Korea: a population-based cross-sectional study. BMJ Open. 2018;8(4):e020656.
58. Fisher BJ, Kraskauskas D, Martin EJ, et al. Attenuation of Sepsis-Induced Organ Injury in Mice by Vitamin C. JPEN J Parenter Enteral Nutr. 2014;38(7):825-839.
59. Carr A, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9:1211.
60. Rodrigues FA, Santos AD, de Medeiros PHQS, et al. Gingerol suppresses sepsis-induced acute kidney injury by modulatingmethylsulfonylmethane and dimethylamine production. Sci Rep. 2018;8(1):12154.
61. Jayaprakasha GK, Rao LJM. Chemistry, Biogenesis, and Biological Activities of Cinnamomum zeylanicum. Critical Reviews in Food Science and Nutrition. 2011;51(6):547-562.
62. Rao PV, Gan SH. Cinnamon: A Multifaceted Medicinal Plant. Evidence-Based Complementary and Alternative Medicine. 2014;2014:1-12.
63. Zhuang M, Jiang H, Suzuki Y, et al. Procyanidins and butanol extract of Cinnamomi Cortex inhibit SARS-CoV infection. Antiviral Research. 2009;82(1):73-81.
64. Simmons G, Bertram S, Glowacka I, et al. Different host cell proteases activate the SARS-coronavirus spike-protein for cell–cell and virus–cell fusion. Virology. 2011;413(2):265-274.
65. Shahzad A, Cohrs RJ. In vitro antiviral activity of honey against varicella zoster virus (VZV): A translational medicine study for potential remedy for shingles. Transl Biomed. 2012;3(2):2.
66. Watanabe K, Rahmasari R, Matsunaga A, et al. Anti-influenza Viral Effects of Honey In Vitro: Potent High Activity of Manuka Honey. Archives of Medical Research. 2014;45(5):359-365.
67. Chua LS, Abdul-Rahaman NL, Sarmidi MR, et al. Multi-elemental composition and physical properties of honey samples from Malaysia. Food Chemistry. 2012;135(3):880-887.
68. Dong C, Li X, Song Q, et al. Hypokalemia and Clinical Implications in Patients with Coronavirus Disease 2019 (COVID-19).Infectious Diseases (except HIV/AIDS). 2020.
69. Sulaiman SA, Hasan H, Deris ZZ, et al. The Benefit of Tualang Honey in Reducing Acute Respiratory Symptons Among Malaysian Hajj Pilgrims: A Preliminary Study. J Api Prod Api Med Sci. 2011;3:38-44.
70. Hashem H. In Silico Approach of Some Selected Honey Constituents as SARS-CoV-2 Main Protease (COVID-19) Inhibitors; Chemistry. 2020.
71. Hossain KS, Hossain MG, Moni A, et al. Prospects of honey in fighting against COVID-19: pharmacological insights and therapeutic promises. Heliyon. 2020;6(12):e05798.
72. Aparicio-Soto M, Sánchez-Hidalgo M, Rosillo MÁ, et al. Extra virgin olive oil: a key functional food for prevention of immuneinflammatory 
diseases. Food Funct. 2016;7(11):4492-4505.
73. Bonura A, Vlah S, Longo A, et al. Hydroxytyrosol modulates Par j 1-induced IL-10 production by PBMCs in healthy subjects. Immunobiology. 2016;221(12):1374-1377.
74. Casas R, Estruch R, Sacanella E. The Protective Effects of Extra Virgin Olive Oil on Immune-mediated Inflammatory Responses.EMIDDT. 2017;18(1):23-35.
75. Gambino CM, Accardi G, Aiello A, et al. Effect of Extra Virgin Olive Oil and Table Olives on the ImmuneInflammatory Responses:Potential Clinical Applications. EMIDDT. 2017;18(1):14-22.
76. Majumder D, Debnath M, Sharma KN, et al. Olive oil consumption can prevent non-communicable diseases and COVID-19:Review. CPB. 2022;23(2):261-275.
77. Maideen NMP. Prophetic Medicine-Nigella Sativa (Black cumin seeds) - Potential herb for COVID-19? J Pharmacopuncture.2020;23(2):62-70.
78. Islam MN, Hossain KS, Sarker PP, et al. Revisiting pharmacological potentials of NIGELLA SATIVA seed: A promising option forCOVID ‐19prevention and cure. Phytotherapy Research 2021;35(3):1329-1344.
79. Bouchentouf S, Missoum N. Identification of Compounds from Nigella Sativa as New Potential Inhibitors of 2019 Novel Coronasvirus (Covid-19): Molecular Docking Study, Chemistry. 2020.
80. Menon VP, Sudheer AR. Antioxidant and Anti-inflammatory Properties of Curcumin. In The Molecular Targets and Therapeutic Uses of Curcumin in Health and Disease; Advances in Experimental Medicine and Biology; Springer US: Boston, MA.
81. Srivastava RM, Singh S, Dubey SK, et al. Immunomodulatory and therapeutic activity of curcumin. International Immunopharmacology. 2011;11:331-341.
82. Avasarala S, Zhang F, Liu G, et al. Curcumin Modulates the Inflammatory Response and Inhibits Subsequent Fibrosis in a Mouse Model of Viral-induced acute respiratory distress syndrome. PLoS ONE. 2013;8(2):e57285. pone.0057285
83. Hosseini A, Rasaie D, Soleymani Asl S, et al. Evaluation of the protective effects of curcumin and nanocurcumin against lung injury induced by sub-acute exposure to paraquat in rats. Toxin Reviews. 2019;1-9.
84. Chen H, Yang R, Tang Y, et al. Effects of curcumin on pulmonary fibrosis and functions of paraquat-challenged rats. 2017;29(11):973-976.
85. Gautam SC, Gao X, Dulchavsky S. Immunomodulation by Curcumin. In The Molecular Targets and Therapeutic Uses of Curcumin in Health and Disease; Springer US: Boston, MA. 2007;595:321-341.
86. WHO monographs on selected medicinal plants; World Health Organization, Ed.; World Health Oganization: Geneva; 1999.
87. Santiago de Chile; Ministerio de Salud MHT: traditional herbal medicines: 103 plant species. 2010.
88. Kuete V. Thymus vulgaris. In Medicinal Spices and Vegetables from Africa; Elsevier. 2017;599609.
89. Salehi B, Abu-Darwish MS, Tarawneh AH, et al. Thymus spp. plants - Food applications and phytopharmacy properties. Trends in Food Science and Technology. 2019;85:287-306.
90. Nolkemper S, Reichling J, Stintzing FC, et al. Antiviral effect of aqueous extracts from species of the Lamiaceae family against Herpes simplex virus type 1 and type 2 in vitro. Planta Med. 2006;72(15):1378-1382.

Most read articles by the same author(s)

<< < 1 2 3 4 5 6 7 8 9 10 > >>