Dietary recommendations during Covid - A perspective

Dr Wricha Tyagi *

The outbreak of second wave of COVID-19 in NE India has opened up a new challenge to this part of the country. The idea of mitigating the effects of the second wave through balanced diet holds promise, especially when this region is one of the biodiversity hotspots and clinical evidence exists supporting the role of balanced diet in minimizing risk of infection and aiding faster recovery.

The role of Zn (inhibits replication of this RNA virus); vitamin D (decreases production of pro-inflammatory cytokines, thereby reducing the risk of pneumonia); polyphenols (inhibitory effect on virus entry through ACE2 receptors and spike proteins); probiotics (increases bacteriocins in gut and reduce chances of ventilator associated pneumonia) and polyunsaturated fatty acids (PUFAs) (having several benefits like reducing viral replication, reduction in virus severity, glucoregulatory and anticoagulant properties) is now well documented.

Role of microorganisms (specially present in the gut of human beings) in immune response is now proven. Psychobiome refers to the gut microbiome which influence the neurosystem and scientific proof exists that mental disorders like anxiety, depression, OCD and ADHD are directly related to the gut microbiome. Role of biological rhythm or circadian rhythm in various biological processes is well-documented.

Every living organism has a rhythm and this circadian rhythm can be diurnal, seasonal and/or developmental. In order to have a robust immune system it is imperative that good microbes are present and in sync with our circadian rhythm. Any disturbances in this will lead to disturbance in digestive system, leading to unabsorbed or undigested food and this will ultimately affect the immune response.

The dietary recommendations that are emerging based on studies available from various parts of the world and recommendation of WHO are as follows:

Eat fresh, unprocessed and seasonal foods every day
Try eating seasonal/local produce.

Eat fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice or starchy tubers or roots such as potato, yam, taro or cassava), and foods from animal sources (e.g. meat, fish, eggs and milk).

Foods containing vitamin D include ûsh, liver, egg yolk and foods (e.g., milk, yogurt) with added vitamin D.
Among the dietary sources of zinc are oysters (the most zinc per serving), poultry, red meat, nuts, pumpkin seeds, sesame seeds, beans, and lentils.
Polyphenols can be found in coloured fruits like strawberries, berries; spices like turmeric, ginger; vegetables like onions, spinach, etc.
Daily, eat : 2 cups of fruit (4 servings), 2.5 cups of vegetables (5 servings), 180 g of grains, and 160 g of meat and beans (red meat can be eaten 1-2 times per week, and poultry 2-3 times per week).

For snacks, choose raw vegetables and fresh fruit rather than foods that are high in sugar, fat or salt.
Do not overcook vegetables and fruit as this can lead to the loss of important vitamins.
When using canned or dried vegetables and fruit, choose varieties without added salt or sugar.

Drink enough water every day
Water is essential for life. It transports nutrients and compounds in blood, regulates your body temperature, gets rid of waste, and lubricates and cushions joints.
Drink 8–10 cups of water every day.
Water is the best choice, but you can also consume other drinks, fruits and vegetables that contain water, for example lemon juice (diluted in water and unsweetened), tea and coffee. But be careful not to consume too much caffeine, and avoid sweetened fruit juices, syrups, fruit juice concentrates, fizzy and still drinks as they all contain sugar.

Eat moderate amounts of fat and oil
Consume unsaturated fats (e.g. found in fish, avocado, nuts, olive oil, soy, canola, sunflower and corn oils) rather than saturated fats (e.g. found in fatty meat, butter, coconut oil, cream, cheese, ghee and lard).

Choose white meat (e.g. poultry) and fish, which are generally low in fat, rather than red meat.
Avoid processed meats because they are high in fat and salt.
Where possible, opt for low-fat or reduced-fat versions of milk and dairy products.
Avoid industrially produced trans fats. These are often found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads.

Eat less salt and sugar
When cooking and preparing food, limit the amount of salt and high-sodium condiments (e.g. soy sauce and fish sauce).
Limit your daily salt intake to less than 5 g (approximately 1 teaspoon), and use iodized salt.
Avoid foods (e.g. snacks) that are high in salt and sugar.

Limit your intake of soft drinks or sodas and other drinks that are high in sugar (e.g. fruit juices, fruit juice concentrates and syrups, flavoured milks and yogurt drinks).
Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate
Caution: Prolonged use of high dose of Vitamin D is known to have adverse effects and probiotics should only be taken after consultation with health physician.

Sources: WHO; European Journal of Clinical Nutrition (2020) 74:850–851; AdvNutr 2021;00:1–13

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