Nutrition is one of the important factors to help you overcome Covid-19. Nutrition helps to support and improve the ‘barrier’ to protect the body, such as immune cells, antibodies, skin, mucous membrane and stomach lining.

A good diet requires proper energy balance with enough proteins, fat, carbohydrates, vitamins, minerals, probiotics fibres and water.

GENERAL PRINCIPLES

• Eat full 3 main meals, supplement nutrition for extra meals if you eat poorly (such as high-energy nutritious milk, soy milk, nut milk, yogurt, fruit smoothies, cakes, etc.) to ensure enough energy for your body.
• Eat a variety of different foods with different colours.
• Drink enough water (from 2 to 2.5 litres/day), drink slowly, small sips, even if not thirsty, avoid soft drinks but take instead fresh fruit juices which are rich in vitamin C to strengthen body resistance.
• You should consult your doctor about the diet if you suffer from a chronic disease such as diabetes, high blood pressure, bad cholesterol, liver or kidney disease.

For a healthy body and a good immune system, in addition to eating right, it is also necessary to have a proper exercise regimen. Patients can exercise regularly according to their health status, even at home. It is necessary to maintain a healthy lifestyle: get enough sleep, do not abuse alcohol, do not smoke, have an optimistic spirit.

For patients with Covid-19 who have symptoms of loss of smell, taste, anorexia, or patients with chronic diseases, the issue of nutritional supplements needs special attention. At this time, you should consult a medical nutritionist or a dietician to receive specific supplementary instructions, specify alternative foods, supplements or provide nutrients by some more suitable method. It is important to help patients stay healthy and improve their immune system to overcome the disease.

NUTRITIONAL RECOMMENDATIONS FOR LONG COVID-19 PATIENTS

Long Covid refers to the effects of Covid-19 that last for weeks or months after the initial illness.

Tips for eating when you are short of breath 

Eating can be very challenging when you are short of breath so try to:

• Eat smaller portions of energy and protein-rich foods more frequently throughout the day;
• Select foods that are softer and moister, making them easier to chew and swallow;
• Enjoy your meal at your own pace.

Tips for managing a dry mouth 

The use of nebulisers, inhalers, and oxygen therapy can all cause dry mouth. It can make chewing and swallowing foods difficult, and it can sometimes cause taste changes.

• Drink 6 to 8 cups of fluid per day (including nourishing fluids like milky drinks or juices).
• Add sauces such as gravy, mayonnaise, salad cream, and cheese sauce to foods, and choose moist dishes like stews.
• Suck sugar-free sweets or chew sugar-free gum to help saliva production.
• Rinse and gargle with water after using an inhaler to keep your mouth fresh.

If you are having difficulty swallowing, coughing regularly during meals, or your voice becomes  garbled, ask your healthcare professional to refer you to a speech and language therapist to check your swallowing and provide further advice. 

Tips for managing changes to taste and smell 

Changes in taste and smell are frequent Long Covid-19 symptoms that can make eating and drinking less pleasurable:

• Experiment with herbs, spices, pepper, chutneys, and pickles in cooking;
• If you dislike the strong flavour of hot foods, try cold foods instead;
• If you go off a particular food, try it again regularly as your tastes may continue to change. 

Tips for making the most of your food 

It can be difficult to eat well when you’ve lost your appetite, try some of the suggestions below:

• Eat more of the foods that you enjoy at the times of day when you feel more like eating;
• Eat smaller meals with snacks and nourishing drinks (e.g. smoothies, soups, fruit juice, milkshakes or hot chocolate) in between;
• Avoid drinking before or during meals, as the liquid can fill you up;
• Add ingredients such as cream, cheese, butter, olive oil, cream cheese, milk powder, and ground almonds to foods like soups, stews, curries, scrambled eggs, vegetables, potatoes;
• Add honey, syrup, and jams to porridge, milky puddings, on bread, toast, or tea cakes;
• To make your regular milk more nutritious, whisk 2-4 tablespoons skimmed milk powder into a half-litre of milk;
• If you usually eat low fat, low sugar ‘diet’ foods and drinks, switch to non-diet ones (e.g. whole milk) and have some treats between meals or as a snack, such as a piece of cake, chocolate, a handful of nuts, or a biscuit.

To recover from Long Covid symptoms, you must also supplement with essential nutrients. Some vitamins (A, B6, B12, C, folate, and E) and trace elements (zinc, copper, selenium, and iron) have been shown to improve the immune system. These are best obtained through a well-balanced diet that includes:

• Milk and cheese – the source of vitamin A and B12
• Fish and oily fish – the source of vitamins A, B6, and B12 and Selenium
• Green leafy vegetables such as kale, spinach, and broccoli – the source of vitamins A and B6, folate, and iron
• Nuts and seeds – the source of vitamin E, copper, and iron
• Meat – the source of zinc, iron, selenium, and vitamins B6 and B12
• Fruits – the source of vitamin A and C.

Vitamin D also plays a role in the immune system and low levels have been associated with an increased risk of infection and respiratory diseases.

LOW-HISTAMINE DIET

The low-histamine diet has received some attention in Long Covid. Mast cell activation syndrome is thought to play a role in Long Covid, and mast cells release histamine, a chemical associated with inflammation. Because histamine can be found in some foods, a low histamine diet may be beneficial in the treatment of Long Covid.

Here are some examples of high-histamine foods:

• Cured and aged meat
• Oily fish and shellfish
• Fermented dairy including aged cheese, yogurt, and kefir
• Eggs
• Deli chicken and turkey slices
• Some fruit and vegetables, spices, nuts and fermented foods.

However, this is only a theory at the moment, with no direct evidence to back it up. Furthermore, because the low-histamine diet is so restrictive, it is not appropriate for everyone and should only be tried for a limited time under the close supervision and support of a registered dietician.

Oral Nutritional Supplements (ONS) should be used whenever possible to meet your calories needs, when dietary counselling and food fortification are not sufficient to increase dietary intake and reach nutritional goals. ONS shall provide at least 400 kcal/day including 30g or more of protein/day and shall be continued for at least one month. Efficacy and expected benefit of ONS shall be assessed once a month.

FV doctors and nutritionists can provide advice on nutrition, design customised menu specifically for you that you can prepare and cook at home, advice about nutritional supplements and even organise meals prepared by FV Kitchen to be delivered to your home.

You can book an appointment with doctors of FV Department of Nutrition & Dietetics, via phone number (028) 54 11 33 33, extension 1419.