Nutrition and well being for Long Covid recovery

Nutrition and wellbeing for post Covid recovery.

We are only just beginning to understand all the different ways Covid can affect individuals in the long term. What we do know is that everyone is unique as will react and recover from Covid in different ways.

However, we know that taking care of your physical and mental wellbeing by eating nourishing balanced meals and snacks and taking as much physical activity as you are able as well will help you recover as quick as possible. Keeping a check on your mental wellbeing is also important as is seeking help when you need it.

Taking control of your diet and lifestyle can also help you feel empowered, at a time when so much is out of our control. The following notes will guide you through the principles of a balanced diet to aid a speedy recovery from the virus. There are also links at the end to the NHS information and other useful websites.

  1. Optimum nutrition will mean you are helping your immune system to work at its optimum– you don’t want a boosted immune system.

Your body’s immune system is working hard to recover, and it is important to support that immune system with all the key nutrients it needs.

The key nutrients and good sources for immunity are the vitamins A (liver and the brightly coloured veg like carrots and green leafy veg), the B vitamins, C (citrus fruits, sweet peppers, kiwis, and berries) E (vegetable oils and nuts and seeds) and vitamin D.

The most important minerals are zinc (meats, shellfish, nuts and seeds), iron (red meats and the brown meat in chicken as well as green leafy veg), selenium (brazil nuts and all veg) and copper.

All of these, except vitamin D, can be derived from a healthy balanced diet. Vitamin D has been linked to reduced rates of respiratory infections and prevents the immune system from over shooting – in effect overreacting. If you don’t already do so start taking a vitamin D supplement – the only supplement the NHS recommends during the winter months.

We also need enough omega 3 fats these are particularly important in the recovery phase. They make up all our cell membranes. The best source is oily fish -tuna (sorry not tinned) mackerel, salmon and sardines, but if you are vegetarian think about including ground linseeds (same as flaxseeds and great for gut health) and a range of other nuts and seeds. If you don’t like oily fish, take a fish oil supplement.

Finally make sure you eat some protein at each meal, the body likes to use it in pulses during the day. It’s a key part of the recovery process (see below for sources of protein)

If you don’t regularly include these foods gradually, start introducing them to support your immune system.

  1. Supplements

If you eat a healthy balanced diet you really don’t need supplements, however vitamin D3 – 10 ug/day in the winter months and omega 3 – fish oil (or vegetarian equivalent) supplement would aid recovery, for the reasons stated previously.

A high dose supplement may not only be costly but can do you harm. For example high doses of vitamin A are toxic.

You can’t overdose on food and the amazing chemical interactions that happen when we eat, cannot be reproduced by a generic chemical.

  1. Keep your gut microbiome healthy and happy, these are now known to be a key factor in not just immune health but also our mood. You may have heard of the gut brain axis?

You feed the billions of bacteria in your gut with the fibre you can’t digest and the more variety they get the more benefits you will get – the metabolites that they produce are constantly educating our organs and our immune system.

If you combine the past 3 points with enough sleep, exercise/being active and managing your stress levels and you are doing everything you can to keep immune system supported and give yourself the best chance of a speedy recovery.

Aim for 30 different types of fibre a week – and 30g fibre a day. This make take a few weeks to achieve.

Here are the five fibre groups.

  • Fruit and veg.
  • Nuts and seeds.
  • Wholegrains
  • Herbs and spices
  • Pulses like lentils and beans

Aim for at least 7 different types of veg and fruits every day. Variety is key and fresh and frozen all count.

Every different type of fruit and veg, grain and pulse (like lentils) contain different nutrients and fibres to nourish us and our microbiome. – EAT THE RAINBOW!

Constipation has been a common symptom of long Covid so try to eat more fibre – you need to aim for 30g/day alongside drinking enough water.

If you have had to take antibiotics much of your microbiome in your gut may have been affected and if you are suffering from bowel symptoms a course of probiotics (the live good bacteria in your gut) may well be a good idea. IBS symptoms have been on the increase throughout the pandemic, due the stress we are all under and the link between the gut and the brain is well known now. Eating a balanced diet with lots of different fibres can really help your mood.

Two probiotics who have the evidence base to prove the bacteria survive to the gut are Vivomixx and Symprove. All the evidence is on their websites.

  1. Hydration, alcohol and caffeine.

Keep hydrated – dehydration affects your all your bodies metabolic processes.

Be aware of the effects of alcohol.

You may have been drinking a bit more to relax and to reduce your anxiety level, but your body will react to alcohol.

Its known as the ‘Seesaw’ effect – your body maintains a careful equilibrium and alcohol blocks certain anxiety receptors – the more you drink the more it blocks – to keep the status quo the body compensates, and you will feel more anxious and stressed out the next day.

Your body also uses alcohol as fuel before fats, protein or carbs - so it will run on these empty calories first before burning your food as fuel. It also increases your feeling of hunger and dampens your resolve to eat better…It also disrupts our sleep patterns and too much affects the gut microbiome.

Caffeine affects us all differently – we are as unique in our metabolism of different foods as we are in our personalities. If you have sleep issues – which are very common with long Covid - be aware of how much you are drinking. If you are constantly tired it is simply your body making you rest so listen to it and nourish it.

  1. Nourish your body by eating a balanced diet including foods from all the main food groups and drop any faddy diets that exclude food groups.

Your body is working hard recover and you need to give it all the nutritional support to do that. If you exclude a food group for any other reason than a medical one you are more likely to be deficient in one or more nutrients to Unless you have an allergy like coeliac disease, include all the food groups. The first 3 food groups (see below) should contain around a third of what you consume over a day with the addition of good fats at @10-20% of your daily intake.

Proteins – meats, fish, dairy, eggs and pulses, etc protein is needed to help your body repair and you may well have lost muscle. Your body likes pulses of protein throughout the day – so make sure you included it at every meal.

Carbohydrates – rice, pasta, breads, potato and grains – do make sure you eat the wholegrain version of all of these – they give you more fibre key for digestive health and often post Covid can mean constipation, particularly if you are not able to be active. Carbohydrates often get a bad press but like most things in nutrition there is a spectrum with wholegrains and pulses as complex carbs at one end to refined sugar and syrups at the other end.

Carbs are your brains preferred source of energy and they also are needed to mobilize protein round your body – did you also know that insulin – the hormone that is released when you eat carbs is also responsible for enabling protein to repair the muscles and tissues throughout the body?

Eating wholegrain versions and including pulses in dishes like soups or sauces is a great way to keep your body well fuelled and your gut bacteria happy.

Vegetables and fruits – variety is key, frozen and tinned are fine but try and eat the rainbow in a week as each colour has a different vitamin, mineral or antioxidant.

Fat – fat is important to include in your diet. Once again, it’s about the type of fat – good fats are key for keeping your cardiovascular system healthy as well as helping repair and recover.

Good fats to include – oily fish, nuts and seeds like linseeds, pumpkin seeds, olive oil and avocados.

Saturated fats and those found in processed foods should be eaten in moderation.

  1. Avoid heavily processed foods.

Again, processed foods have a bad press but there is a spectrum. Tinned beans and tomatoes are processed but are cheap and useful ingredients in many dishes. However, the ultra-processed foods like doughnuts and biscuits are really just providing what is termed as ‘empty calories’, energy without any nutrients. We all need to eat less of these, no foods are off limits but to help support your recovery process your body needs all the nutrients it can from a balanced diet.

That said food gives us pleasure and a great sense of joy, particularly sharing it with our loved ones so do have that occasional biscuit or chocolate, whatever it is you enjoy, but make sure you savour it and keep it to one, not half a packet. It may also be that you are eating out of boredom not hunger – will that chocolate bar actually entertain you or do you need to take a break?

  1. Manage your home food environment.

To enable you to eat a balanced nourishing diet you need to manage your food environment and plan your meals. We eat for convenience and with our eyes – so if there is a half open packet of biscuits or a full fruit bowl makes a difference to what choose.

Put out bowls of fruit and nuts or have some frozen berries with yogurt or houmous. Make sure you have easy to grab nourishing and tasty snacks and meals.

You have control over your food environment now more than ever – what you don’t buy you can’t eat!

Planning is key – it make take time but as we are all having to cut down on trips to the super-market, we need to put in more thought about what we buy. This is a habit that will enable you to continue eating well after you are fully recovered as well as benefiting the whole family.

  1. Eat mindfully at each meal and to satisfaction.

If you are back at work take a break for lunch and make sure it satisfies you - include plenty of fibre (from grains and fruits and veg) and protein to help keep you alert in the afternoon. Your meals should satisfy your true hunger.

  1. Sleep and physical activity

Sleep is really important for recovery, but insomnia has been a common symptom with post Covid. Have a look at the NHS website at the end for some good tips, and further help if you need it.

Be as active as you can even though you may feel tired but don’t overdo it. If short walk is all you can manage then leave it there.

  1. Food is a great source of joy as well as nourishment.

I truly believe healthy food doesn’t have to be boring or tasteless, or take you ages to prepare.

Recipes in a slow cooker are ideal as are soups with lots of veg and easy to grab snacks like Greek yogurt and frozen berries or some peanut butter and apple. Perhaps roast a chicken and use the meat in sandwiches, risottos and soups? Or roast extra vegetables the night before which you can use at lunchtime.

The NHS resource for Covid recovery is below and has some useful information.

These notes are generic if you have any specific nutritional questions or issues do get in touch.