Nutritional Recommendations And Tips For COVID-19 Patients

There is no doubt that at an individual level; diet plays an increasingly important role in one’s immunity and disease susceptibility. There are many studies conducted that testified that specific nutrients or nutrient combinations may affect the immune system through activation of cells, modification of production of signaling molecules, and subsequently gene expression.

Western Diet (popularly known as WD) is a diet high in saturated sugar and refined carbohydrates. This diet can contribute a lot to type 2 diabetes and obesity, and could be a deterministic factor for increased risk of COVID-19 pathology and subsequent mortality.  The problem with WD is the consumption of highly refined carbohydrates and saturated sugar activates the innate immune system and deteriorates adaptive immunity. The impairment of adaptive immunity leads to chronic inflammation caused by the virus and subsequently destroyed the host’s defense against the virus.

Diets that are high in saturated fatty acids (SFAs) can lead to activation of the innate immune system and impairment of the adaptive immune system. People are having lots of SFA can induce a lipotoxic state, which eventually activates the innate immunity system via activation of toll-like receptor 4 expressed on body defensive warriors such as macrophages, dendritic cells, and neutrophils. This triggers activation of canonical inflammatory signaling pathways and that increases pro-inflammatory mediators of the innate immune system.

This is particularly relevant to COVID-19 cases where patients have an infection in lung alveolar epithelial cells and involvement of lung tissue inflammation and partial damage of the cells.

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Significant Role of Vitamins and Minerals in COVID-19

Our body’s defense system is always active, and it is more active in younger people, and gradually weakens in older people. Therefore, it is important to take care of nutrition, especially in elderly people. The defense system in the body is multi-level and suddenly hyper-active when the body becomes infected. When the body is infected, the activities of antibodies are heightened which is characterized by an increased rate of metabolism. When the metabolism is increased, the body needs energy sources, substrates for biosynthesis, and regulator molecules, which are actually derived from the day-to-day diet. In this case, vitamins and minerals such as zinc, copper, selenium, and iron play a significant role.

Why Nutrition is an Integral Component for Severe COVID-19 Patients?

Critical illness exists in phases: a) early acute b) late acute c) post-acute

  • During the early acute phase, hyper-catabolism is the general rule; it means metabolism is at its peak and the body demands good nutrition.
  • During the acute stage, amino acids are mobilized predominately from muscle, which leads to negative nitrogen balance and acquired sarcopenia (muscle loss).
  • Critical illness induces gut dysfunction and dysbiosis, which accentuates the inflammatory response and downstream organ dysfunctions.

Key Recommendation #1

Estimated Needs:

  • 15-20 kcal/kg actual body weight (ABW/day)
  • 1.2- 2 gm protein/kg ABW/day

If refeeding syndrome risk is there

Start at 25% of caloric goal with slow increase

Frequent monitoring of serum phosphate, magnesium and potassium level

Key Recommendation #2 and #3

Initiate enternal nutrition (EN) early

  • Within 24-36 h of ICU adm
  • Within 12 h of incubation

General Nutrition Recommendations for COVID-19 Patients

  • Choose food rich in vitamin A, C, E, B6, and B12, zinc, and iron. Foods such as citrus fruits, dark leafy vegetables, nuts, and dairy products have all the necessary nutrients. For protein intake, animal protein such as meat and eggs are great sources. For people who are non-vegetarian, an appropriate amount of lentils, nuts, soybean, and dairy products are recommended.

  • Regular exercise that leads to sweating helps in maintaining body homeostasis. A healthy lifestyle including appropriate sleep, avoidance of smoking, alcohol, and drugs are quintessential parts of good immunity.

  • Eat fruits daily (guava, apple, banana, strawberry, cantaloupe melon, grapefruit, pineapple, papaya, orange, Longman fruit, blackcurrant, pummelo) with a serving size of two cups (4 servings).

  • Use nuts like almonds, coconut, and pistachio.

  • Drink 8–10 glasses of water every day. It helps to transport nutrients in the blood, gets rid of waste, and regulates body temperature.

  • A healthy lifestyle including regular exercise, proper sleep will positively affect immune functioning.

General Nutritional Tips to Combat COVID-19 at Home

  • Buy only what you need. There are many cases of over-purchasing that have very negative consequences such as an increase in food prices, overconsumption of food, and unequal distribution of food products.

  • Prioritize fresh food products over non-perishable products. Buy vegetables, dairy products, and fresh meat and fish. Avoid frozen products.

  • Always be aware of portion sizes. Sometimes being at home for an extended period of time, especially if you are alone, you tend to overeat, so seek guidance through national food-based dietary guidelines and take the right portion.

  • It is very important to follow safe food handling practices. Keep your hand sanitized before you use your kitchen, utensils, and other items. Separate raw and cooked food and keep it at a safe temperature, either below 5 degrees centigrade or above 60 degrees centigrade.

  • To make your immunity in optimal function, limit your sugar intake. If you crave sweets, eat fruits than refined sugar. If your sweet craving is too much then eat desserts that are low in sugar. Avoid all types of carbonated drinks, even drinks labeled ‘sugar-free’.

  • Take care of your fat intake, and limit it. It is best to avoid trans fats as much as possible. You must read the nutrition labels of the packaged food items to make sure that partially hydrogenated oils are not a part of their ingredients. To make your immunity better, avoid trans fats such as fried and processed food, doughnuts, pie crusts, frozen pizzas, cookies, crackers, and margarine.

  • Stay Hydrated and avoid alcohol. Good hydration is absolutely necessary for good health, especially when there is a virus pandemic. It helps to circulate your nutrition to your body, and also helps to digest food. Alcohol weakens your immunity system and undermines your body’s functionality to cope up with infectious diseases including COVID-19.

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