Pentadecanoic acid (C15:0) and heptadecanoic acid (C17:0) are odd-chain fatty acids, mainly described in dairy products, as they constitute 1% and 0.5% of total ruminant milk fatty acids. They are thus often considered as plasma biomarkers of dairy intake. Yet, their detection in some non-dairy foods has challenged this exclusivity. To identify the dietary sources of OCFAs, a broad food panel was analyzed by GC-MS, including dairy (cheese, yogurt, butter & mldr;), meat (beef, pork, chicken & mldr;), different fish species and fish oils, vegetal oils, fruits and vegetables etc. Results confirmed that C15:0 and C17:0 represented on average 1.5% and 0.8% of total fatty acids in dairy products. C15:0 was almost exclusively abundant in dairy, whereas C17:0 also appeared in notable amounts in beef and, to a lesser extent, pork. Low amounts of C15:0 and C17:0 were detected in fish, whereas higher amounts of C17:0 were found in fish oils. Thus, dairy products remain the richest source of C15:0, containing the highest amounts per portion.

BACKGROUND:Improving n-3 polyunsaturated fatty acids (PUFAs) dietary intake could modify the characteristics of breast milk. The "Bleu-Blanc-Cœurr" (BBC) food products display increased α-linolenic acid (ALA) content compared with standard food items. OBJECTIVES:This study aims to evaluate whether improving ALA dietary intake by animal and vegetal BBC products during pregnancy and lactation increases ALA content of breast milk on day (d) 21 postpartum (PP) (primary aim), modifies the fatty acids (FAs), human milk oligosaccharides (HMOs), hormone and immune composition of breast milk, as well as the intestinal microbiota of neonates (secondary aims). METHODS:In a single-center, interventional, randomized, open-label trial, adult females, ≤28 wk of amenorrhea, substituted (BBC group) or not [control group (CTRL)] their usual food with BBC animal and vegetal products containing ALA from month 7 of pregnancy until d45-PP. Food intake, breast milk FAs, lipidome, insulin, leptin, adiponectin, interleukin (IL)-6, lactoferrin, immunoglobulin (Ig) A and G, HMOs, and the fecal microbiota composition of neonates were analyzed. RESULTS:Of the 66 included and randomly assigned females, 58 were analyzed. In breast milk, ALA and n-3 PUFA levels were, respectively, 75% and 52% higher at d21-PP, and 38% and 22% higher at d45-PP, in the BBC (n = 28) than in the CTRL (n = 30) groups. At d21-PP, the breast milk lipidome, insulin, IL-6, IgG (P < 0.05), and HMO levels (P < 0.01) differed. The alpha-diversity of the fecal microbiota of neonates at d21-PP was greater (P < 0.05) in the BBC than in the CTRL groups. CONCLUSIONS:Improvement in alpha-linolenic acid dietary intake modifies nutritional and non-nutritional characteristics of breast milk, as well as the fecal microbiota of neonates. Whether this could lead to potential health benefits deserves further investigation. This trial was registered at clinicaltrials.gov as NCT03805997.

Most current dietary guidelines for the prevention of cardiovascular diseases (CVD) recommend the consumption of low-fat dairy in place of regular-fat dairy foods, one of the main sources of dietary saturated fatty acids (SFAs). Here, we summarize the data presented and discussions held-relating to the validity of such recommendations-between a panel of international nutrition research experts at a high-level closed workshop on "Saturated Fat in Dairy and Cardiovascular Diseases," which took place in Amsterdam on 15-16 April, 2024. The most recent evidence indicates that overall, consumption of milk, yogurt and cheese, irrespective of fat content, is neutrally associated with CVD risk. There is also no evidence yet from randomized controlled trials that consumption of regular-fat milk, yogurt, and cheese has different effects on a broad array of cardiometabolic risk factors when compared with consumption of low-fat milk, yogurt, and cheese. Thus, the body of evidence does not support differentiation between regular-fat and low-fat dairy foods in dietary guidelines for both adults and children. Strategies focusing primarily on reduction of energy-dense, nutrient-poor foods, the main source of SFAs in Western diets, rather than on the fat content of dairy foods, are more likely to benefit the population's cardiovascular health. Future research is needed to understand better the place of regular-fat and low-fat dairy foods within healthy eating patterns.

Pentadecanoic acid (C15:0) is a saturated odd-chain fatty acid (OCFA), mainly found in dairy products. Its physiological and nutritional effects are still unknown, yet some recent evidences suggest it might be beneficial to human health. Moreover, pentadecanoic acid has recently been suspected of having essential roles in humans, although the mechanisms are not described. We therefore questioned the potential essentiality of this fatty acid (FA). We investigated in vivo the effect of a C15:0 supplementation on essential fatty acid (EFA) deficient Wistar rats. Female rats were fed an EFA-deficient diet 2 weeks before mating, during pregnancy and lactation. Weaned pups were fed the EFA-deficient diet or were switched to a diet supplemented with C15:0 or linoleic acid (LA) for 11 weeks. A control group was fed with EFA during the whole study. Since linoleic acid deficiency is known to induce growth delay, weights were measured throughout the experiment and FA content in collected tissues were analyzed to evaluate biochemical markers of the deficiency. As expected, EFA-deficient rats showed growth retardation, compared to control rats. Supplementation of C15:0 at weaning increased early growth rate compared to deficient animals, as also did the supplementation of C18:2 n-6. Furthermore, the supplementation of C15:0 in the diet of EFA-deficient animals induced the previously undescribed synthesis of odd-chain PUFAs of the n-8 family (C19:3, C21:3 and C21:4 n-8). These results suggest dietary C15:0 might counteract EFA induced growth retardation, possibly through the synthesis of odd-chain n-8 PUFAs, yet mechanisms are to be deciphered for further validation. (c) 2024 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Fatty acid desaturases are key enzymes in lipid metabolism. They introduce double bonds between defined carbons of the fatty acyl chain and catalyze rate-limiting steps in the biosynthesis of polyunsaturated fatty acids. For decades, in vitro desaturase activities have been determined by using radiolabeled fatty acids as substrates, incubated with tissue or cell fractions containing membrane-bound desaturases. However, handling radioactivity is being increasingly complicated due to safety and regulatory concern. Radiolabeled fatty acids are also expensive and many of them are not commercially available. There is therefore a crucial need to develop new methods. Although methods using unlabeled fatty acids as substrates have recently been validated, they are well suited for large tissue samples and did not achieve the same sensitivity as the radioactive ones. Here, we show that negative chemical ionization GC-MS on stable isotope-labeled fatty acids, derivatized to pentafluorobenzyl esters, now offers this opportunity, because of its high sensitivity in the selected ion monitoring mode. By using this simple and affordable improved method, we measured the kinetic parameters of mouse liver Δ6-desaturase for its two main substrates (C18:2 n-6 and C18:3 n-3; 10-13 µM). Moreover, this method enabled to compare Δ5-desaturase apparent Km values (19-22 µM) for its two main substrates (C20:3 n-6 and C20:4 n-3). Finally, we re-evaluated the controversial effect of freezing on desaturase activities by using both frozen rat tissues and cryopreserved human hepatocytes. This safe, reliable and sensitive method may be applied to other enzymatic activities involving fatty acids (elongation, hydroxylation) in miniaturized samples.

Pentadecanoic acid (C15:0, PDA) is an odd and minor fatty acid that has been neglected in the literature until the last decade. Indeed, as a specific fatty acid of dairy fat, PDA was only used as a biomarker of dairy fat consumption. Lately, PDA was first correlated negatively with the incidence of metabolic syndrome disorder, then its physiological effects have been investigated as a protective fatty acid. PDA supplementation has been demonstrated as negatively correlated with elevated levels of leptin, plasminogen activator inhibitor-1 and insulin, and has been shown to exhibit sensitizing insulin effects with activation of AMPK pathway. PDA also reduced the severity of metabolic dysfunction-associated steatohepatitis (MASH), notably through reduced alanine transaminase and pro-inflammatory cytokines levels. The final effect described for PDA is its ability to display anti-inflammatory properties in several pathology models. Hence, considering these multiple effects, the presence of PDA could be associated with a healthier physiological state, this raises the question of whether the presence of PDA in the body, in adequate quantities, is needed to participate to health maintenance. PDA is not synthesized in sufficient quantities endogenously, so it must be provided by the diet, mainly through dairy fat, although other types of food can also contribute to the dietary intake of PDA. Essential fatty acids are described as not being endogenously synthesized in sufficient and required quantities to maintain physiological health. Thus, PDA might gather both conditions to be described as essential, yet further investigations on both criteria are needed to enhance knowledge on this odd chain fatty acid with promising impact as potential protective supplement nutrient.

L'excès d'acide linoléique (LA) alimentaire (> 4 % de l'apport calorique journalier) est associé à des effets délétères qui dépendent du modèle étudié. Il augmente notamment la prévalence de l'adiposité et du surpoids chez l'homme et possède des rôles pro-adipogéniques trans-générationnels chez la souris mais également pro-inflammatoires et pro-stéatosants chez le rat, ce dernier effet étant aussi retrouvé sur le modèle hépatocellulaire HepaRG. Ces effets nécessitent une compréhension plus précise des voies/mécanismes impactés par l'action directe de cet acide gras, ou indirecte, médiée par des métabolites issus de la conversion du précurseur. Cette étude cherche à répondre à cette problématique en explorant en premier lieu l'effet pro-stéatosant du LA, ainsi que celui de 4 métabolites d'intérêt dont 2 Oxlams (oxydized linoleic acid metabolites) : le 9-HODE (9-HydroxyOctaDecadienoic Acid) et le 13-HODE, ainsi que 2 CLAs (conjugated linoleic acid) : le c9,t11 C18:2 (acide ruménique) et le t10,c12 C18:2. Des cellules HepaRG ont été cultivées durant 35 jours (2 semaines de prolifération puis 3 semaines de différenciation) puis incubées durant 1 semaine en présence de différents traitements contenant respectivement les 5 molécules d'intérêt identifiées (LA/9-HODE/13-HODE/c9,t11 C18:2/t10,c12 C18:2) à différentes concentrations, comparées à un contrôle négatif (milieu de différenciation classique à 1,75 % de DMSO). À l'issue de ces traitements, des tests de dosage des triglycérides et de viabilité cellulaire ont été réalisés. Les ARNm codants pour des gènes associés au métabolisme lipidique ont été quantifiés par RTqPCR. Les cellules ont développé une stéatose marquée par l'accumulation de triglycérides intracellulaires pour les traitements LA/c9,t11 C18:2 et dans une moindre mesure t10,c12 C18:2 à 150 μM chacun, sans toxicité cellulaire associée. En revanche aucune accumulation de triglycérides n'a été observée pour les traitements aux HODEs pour les 3 concentrations testées à 125 nM, 250 nM et 500 nM. L'exploration au niveau transcriptionnel semble montrer une variabilité des mécanismes induits dans la mise en place de cette stéatose en fonction des différents traitements. L'expression de MTTP (sécrétion des VLDL) est plus fortement diminuée pour c9,t11 C18:2, au niveau du stress du réticulum endoplasmique (RE) les expressions de DDIT3 et de HSPA5 sont respectivement augmentées pour t10,c12 C18:2 et diminuées pour le LA. CPT1 (bêta-oxydation mitochondriale) est quant à lui plus fortement exprimé pour t10,c12 C18:2. Notre étude montre un effet pro-stéatosant du LA mais aussi des métabolites conjugués associés sur le modèle étudié. Les résultats de l'analyse des expressions géniques permettent de formuler des hypothèses sur les mécanismes sous-jacents expliquant la mise en place d'une stéatose. En fonction des différentes molécules d'intérêt, on observe notamment un impact plus marqué sur la voie de sécrétion des VLDL pour l'acide ruménique, sur la voie du stress du RE pour l'acide linoléique et t10,c12 C18:2, lui-même contrebalancé par une hausse de la bêta-oxydation mitochondriale. Par la suite, des analyses seront réalisées sur d'autres voies du métabolisme et à d'autres échelles (expressions protéiques, activité enzymatiques …) pour compléter ces premières observations.

BACKGROUND The association between omega-3 (ω-3) PUFAs and cognition, brain imaging and biomarkers is still not fully established. OBJECTIVES The aim was to analyze the cross-sectional and retrospective longitudinal associations between erythrocyte ω-3 index and cognition, brain imaging, and biomarkers among older adults. METHODS A total of 832 Alzheimer's Disease Neuroimaging Initiative 3 (ADNI-3) participants, with a mean (SD) age of 74.0 (7.9) y, 50.8% female, 55.9% cognitively normal, 32.7% with mild cognitive impairment, and 11.4% with Alzheimer disease (AD) were included. A low ω-3 index (%EPA + %DHA) was defined as the lowest quartile (≤3.70%). Cognitive tests [composite score, AD Assessment Scale Cognitive (ADAS-Cog), Wechsler Memory Scale (WMS), Trail Making Test, Category Fluency, Mini-Mental State Examination, Montreal Cognitive Assessment] and brain variables [hippocampal volume, white matter hyperintensities (WMHs), positron emission tomography (PET) amyloid-β (Aβ) and tau] were considered as outcomes in regression models. RESULTS Low ω-3 index was not associated with cognition, hippocampal, and WMH volume or brain Aβ and tau after adjustment for demographics, ApoEε4, cardiovascular disease, BMI, and total intracranial volume in the cross-sectional analysis. In the retrospective analysis, low ω-3 index was associated with greater Aβ accumulation (adjusted β = 0.02; 95% CI: 0.01, 0.03; P = 0.003). The composite cognitive score did not differ between groups; however, low ω-3 index was significantly associated with greater WMS-delayed recall cognitive decline (adjusted β = -1.18; 95% CI: -2.16, -0.19; P = 0.019), but unexpectedly lower total ADAS-Cog cognitive decline. Low ω-3 index was cross-sectionally associated with lower WMS performance (adjusted β = -1.81, SE = 0.73, P = 0.014) and higher tau accumulation among ApoE ε4 carriers. CONCLUSIONS Longitudinally, low ω-3 index was associated with greater Aβ accumulation and WMS cognitive decline but unexpectedly with lower total ADAS-Cog cognitive decline. Although no associations were cross-sectionally found in the whole population, low ω-3 index was associated with lower WMS cognition and higher tau accumulation among ApoE ε4 carriers. The Alzheimer's Disease Neuroimaging Initiative (ADNI) is registered at clinicaltrials.gov as NCT00106899.

The association between ω-3 polyunsaturated fatty acids and cognition, brain imaging and biomarkers is still not fully established. We aimed to analyze the cross-sectional and retrospective longitudinal associations between erythrocyte ω-3 index and cognition, brain imaging and biomarkers among older adults. 832 participants from the Alzheimer’s Disease Neuroimaging Initiative 3, mean (SD) age 74.0 (7.9) years, 50.8% female, 55.9% cognitively normal, 32.7% with mild cognitive impairment and 11.4% with Alzheimer’s disease (AD) were included. Low ω-3 index (% eicosapentaenoic acid EPA + % docosahexaenoic acid DHA) was defined as the lowest quartile (≤3.70%). Cognitive tests (composite score; AD Assessment Scale cognitive (ADAS-Cog) subscale; Wechsler Memory Scale (WMS); Trail Making Test A and B; Category fluency; Mini Mental State Examination; Montreal Cognitive Assessment; Clinical Dementia Rating) and brain variables (hippocampal volume, white matter hyperintensities (WMH), PET amyloid-β and Tau) were considered as outcomes in regression models. Low ω-3 index was not associated with cognition, hippocampal and WMH volume, brain Aβ and Tau after adjustment for age, education, ApoE ε4, cardiovascular disease, BMI and total intracranial volume in the cross-sectional analysis. In the retrospective analysis, low ω-3 index was associated with greater Aβ accumulation over time. The composite cognitive score did not differ between groups; however, low ω-3 index was associated with greater cognitive decline on the WMS-Delayed recall but unexpectedly lower cognitive decline on the total ADAS-Cog. Low ω-3 index was cross-sectionally associated with lower performance on WMS tests and higher Tau accumulation among ApoE ε4 carriers. Longitudinally, low ω-3 index was associated with greater Aβ accumulation over time and cognitive decline on the WMS but unexpectedly with lower cognitive decline on the total ADAS-Cog. Low ω-3 index was associated with lower cognition on the WMS and higher Tau accumulation among ApoE ε4 carriers in the cross-sectional analysis.

Apres une periode tres dogmatique, mais en partie explicable, de diabolisation des lipides, les donnees acquises en physiologie et en epidemiologie constituent desormais la base pour une rehabilitation de l’importance de la proportion de lipides dans l’apport energetique, chez l’adulte et chez l’enfant. Des 2010, les apports nutritionnels conseilles (ANC) ont initie cette necessaire revalorisation, confirmee depuis par plusieurs etudes. Meme si cela apparait un peu paradoxal dans le contexte actuel de surpoids et d’obesite de la population, la bonne dose de lipides dans l’alimentation est importante a respecter, en particulier chez le jeune enfant.

Following a long and dogmatic period, which has demonized the dietary lipids, a cautious review of the literature led the scientists to propose a new paradigm and rehabilitation for lipids. French guidelines have endorsed it since 2010, and recent data confirm this new and necessary approach, especially for infants.

Infant formula should provide the appropriate nutrients and adequate energy to facilitate healthy infant growth and development. If conclusive data on quantitative nutrient requirements are not available, the composition of human milk (HM) can provide some initial guidance on the infant formula composition. This paper provides a narrative review of the current knowledge, unresolved questions, and future research needs in the area of HM fatty acid (FA) composition, with a particular focus on exploring appropriate intake levels of the essential FA linoleic acid (LA) in infant formula. The paper highlights a clear gap in clinical evidence as to the impact of LA levels in HM or formula on infant outcomes, such as growth, development, and long-term health. The available preclinical information suggests potential disadvantages of high LA intake in the early postnatal period. We recommend performing well-designed clinical intervention trials to create clarity on optimal levels of LA to achieve positive impacts on both short-term growth and development and long-term functional health outcomes.

Recently, the European Commission issued a Delegated Regulation updating the compositional and information requirements for infant and follow-on formulae that are to be applied at the latest in February 2021. This new regulation changes the status of docosahexaenoic acid (DHA) from an optional ingredient to a mandatory nutrient in these formulae at levels between 20 and 50 mg/100 kcal (0.5–1% of fatty acids). By contrast, arachidonic acid (ARA) becomes an optional nutrient. Following publication of the new regulation, global scientific experts have expressed concerns regarding the potential health risks of new infant formulae containing only DHA, especially at levels higher than those in breast milk and infant formulae marketed to date. Both DHA and ARA play a crucial role in infant development. First, breast milk, the gold standard for infant feeding, contains both DHA and ARA. Second, during development, the conversion of linoleic acid into ARA through desaturation steps is not sufficient to meet nutritional needs, especially in carriers of newly identified genetic variants in fatty acid desaturases, which weaken the biosynthetic production of ARA. Third, circulating levels of DHA and ARA in breastfed infants can only be matched with the addition of both fatty acids to formulae. And fourth, most studies performed to date have demonstrated that important physiological and developmental endpoints are sensitive to the ratio of dietary ARA:DHA. The precautionary principle applies when implementing the new EU regulation for infant and follow-on formulae. As a consequence, given the vulnerability of developing infants as well as the absence of conclusive evidence that formulae with at least 20 mg DHA/100 kcal, but no ARA, are safe and suitable to support the growth and development of infants similar to their breastfed peers, it remains necessary to still market formulas containing both ARA and DHA until proved otherwise.

Maternal n-6 polyunsaturated fatty acids (PUFA) consumption during gestation and lactation can predispose offspring to the development of metabolic diseases such as obesity later in life. However, the mechanisms underlying the potential programming effect of n-6 PUFA upon offspring physiology are not yet all established. Herein, we investigated the effects of maternal and weaning linoleic acid (LA)-rich diet interactions on gut intestinal and adipose tissue physiology in young (3-month-old) and older (6-month-old) adult offspring. Pregnant rats were fed a control diet (2% LA) or an LA-rich diet (12% LA) during gestation and lactation. At weaning, offspring were either maintained on the maternal diet or fed the other diet for 3 or 6 months. At 3 months of age, the maternal LA-diet favored low-grade inflammation and greater adiposity, while at 6 months of age, offspring intestinal barrier function, adipose tissue physiology and hepatic conjugated linoleic acids were strongly influenced by the weaning diet. The maternal LA-diet impacted offspring cecal microbiota diversity and composition at 3 months of age, but had only few remnant effects upon cecal microbiota composition at 6 months of age. Our study suggests that perinatal exposure to high LA levels induces a differential metabolic response to weaning diet exposure in adult life. This programming effect of a maternal LA-diet may be related to the alteration of offspring gut microbiota.

Trans-palmitoleic acid (trans-9 C16:1, or trans-C16:1 n-7, TPA) is typically found in ruminant-derived foods (milk and meat). Of note, previous epidemiological studies associated high levels of circulating TPA with a lower risk of type 2 diabetes and metabolic syndrome in humans. At the current time, TPA intakes in humans are ensured by ruminant-derived foods. However, due to the very low commercial availability of TPA, there are no supplementation studies carried out so far. Therefore, the ability for dietary TPA to prevent type 2 diabetes and metabolic syndrome has never been experimentally assessed. Here, a method (among others) to get dozens of grams of pure TPA as ethyl ester, to perform dedicated supplementation studies, is reported. For that purpose, it starts from food sources containing high amounts of cis-palmitoleic acid (cis-9 C16:1, or cis-C16:1 n-7, CPA), dealing with fatty acids ethyl esters all along the experiment. CPA is purified with flash liquid chromatography, then submitted to a cis/trans isomerization step. Finally, TPA is separated from CPA by low-temperature crystallization in methanol. The final product is fully characterized by H-1 and C-13 nuclear magnetic resonance spectrometry. It is possible to produce approximate to 70 g of 85%-purity TPA suitable for nutritional studies. Practical Applications: The synthesized trans-palmitoleic acid may serve for supplementation (or nutritional) studies aiming at unravelling its physiological impacts suggested by epidemiological work. Depending on the amount of synthesized trans-palmitoleic acid, one may carry out nutritional studies on rodents or even on humans.

High circulating levels of trans-palmitoleic acid (TPA) are associated with a lower risk of type 2 diabetes in humans. Thus, the origin of circulating TPA matters. Direct intakes of TPA are ensured by dairy products, and perhaps by partially hydrogenated oils (PHOs). Indirect intakes of TPA rely on dietary trans-vaccenic acid (TVA), which occurs in ruminant-derived foods and PHOs. As it is usually assumed that PHOs are not used any longer, we analyzed here a wide range of foods currently available at retail in France. We report that TPA and TVA (1) do occur in ruminant milk and meat, dairy products and in foreign PHOs, (2) do occur in dairy fat-containing foods and (3) do not occur in dairy fat-free foods. Together, our findings demonstrate that ruminant fats are the only contributors to circulating levels of TPA in humans.

Paleo guide to OILS AND FATS One of the most important parts of eating Paleo is cutting out harmful oils that are all too common in the typical Western diet. There’s a lot that goes into what makes an oil or fat harmful or not, including whether its fatty acid composition is inflammatory and whether or not it is wrecked if heated too high. By the way, “fat” (lard, butter, etc.) is solid at room temperature and “oil” (corn oil, hazelnut oil, etc.) is liquid at room temperature. Here’s a primer on fats and oils. Use this guide to pick which ones you cook with, pour over salads, or avoid all together.

In around 10% of SARS-CoV-2 infected patients, coronavirus disease-2019 (Covid-19) symptoms are complicated with a severe lung damage called Acute Respiratory Distress Syndrome (ARDS), which is often lethal. ARDS is mainly associated with an uncontrolled overproduction of immune cells and cytokines, called "cytokine storm syndrome"; it appears 7-15 days following the onset of symptoms, leading to systemic inflammation and multiple organ failure. Because they are well-known metabolic precursors of specialized pro-resolving lipid mediators (SPMs), omega-3 long-chain polyunsaturated fatty acids (omega-3 LC-PUFAs) could help improve the resolution of the inflammatory balance, limiting therefore the level and duration of the critical inflammatory period. Omega-3 LC-PUFAs may also interact at different stages of the viral infection, notably on the virus entry and replication. In the absence of demonstrated treatment and while waiting for vaccine possibility, the use of omega-3 LC-PUFAs deserve therefore to be considered, based on previous clinical studies suggesting that omega-3 supplementation could improve clinical outcomes of critically ill patients at the acute phase of ARDS. In this context, it is crucial to remind that the omega-3 PUFA dietary intake levels in Western countries remains largely below the current recommendations, considering both the omega-3 precursor α-linolenic acid (ALA) and long chain derivatives such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). An optimized omega-3 PUFAs status could be helpful to prevent infectious diseases, including Covid-19.