Eat, sleep, breathe, repeat

A healthy and balanced diet along with ample rest and a light exercise regime goes a long way in recovering completely from Covid-19, writes Shwetha Bhatia

Covid is an inflammatory condition that can have lasting effects for months after discharge or initial infection. Here are some basic guidelines for people who are Covid positive or are recovering from Covid-19.

Diet

Aspects that need to be kept in mind include managing other complications if any for eg., hypertension, diabetes, kidney dysfunction, cardiac involvement, digestive disturbances, diarrhoea, loss of taste/smell, difficulty in breathing, difficulty in swallowing especially those who may have been intubated during hospitalisation.

Calories: Adequate calories must be provided depending on the patient’s nutritional status. Patients with obesity are more prone to pneumonia and cardiac stress. Caloric restriction is needed for ensuring healthy fat loss and lean mass maintenance in obese patients. Usually, patients have low activity levels and do not need extra calories.

Protein: Increasing the supplementation of branched-chain amino acids (BCAA) helps to prevent muscle loss and enhances the strength of respiratory muscles. Whey protein is the ideal choice if the budget permits, at least for the first 2-3 weeks. If not, fresh curd, paneer or thoroughly cooked eggs can be given depending on meal preference and digestive function.

Carbohydrates: Excess carbohydrates lead to the production of equal carbon dioxide (called respiratory quotient) which must be avoided to decrease respiratory distress. Opt for pulses, dairy and vegetables over grains. Avoid fruit juices.

Fat: To maintain calories, the proportion of fat can be increased. Give priority to the use of medium-chain fatty acids and omega-3 fatty acids. They play a major role in immune responses and reduce inflammation. Coconut oil, butter, ghee, nuts, MCT oil, omega 3 supplements can be used. Olive oil, rice bran oil, groundnut oil can also be used for cooking.

Vitamins/minerals: Routine supplements of multivitamins and minerals is needed with emphasis on adequate vitamin B/C/D, zinc, and selenium. Vitamins and minerals work like messengers and cofactors in almost 300 reactions in our body.

Immuno-nutrients: These are specific nutrients shown to have a considerable influence on immune function. There are several types such as arginine and most importantly glutamine which supports both the immune and the digestive system. Curcumin (found in turmeric and as capsules) also aids recovery.

Probiotics: The alteration of healthy gut bacteria occurs as a result of infection as well as treatment with antibiotics. Probiotics help to restore immunity.

Fluids and salts: Mild fever and diarrhoea are associated with dehydration. Thin buttermilk, soups, coconut water, salted lemon water and ORS can be consumed.

Meal frequency and consistency: If the patient’s dry cough and sore throat get severe, solid food intake may decrease. Warm, soft foods and supplements can be given as small frequent feeds. Fluid consumption should be in between meals and not with the meal.

Exercise: Prolonged home/ICU stay may lead to a drop in muscle mass. Once the patient is stable and the physician gives a clearance, exercise must be slowly encouraged by monitoring the vitals. Safe, simple, exercises include, breathing and strengthening exercises, activities for balance and control preferably done under guidance.

Finally, patients may need support with their mental health as well.

Other complications

For cardiac and kidney patients, the volume of fluid and sodium, along with other electrolytes may have to be restricted. For diabetics, tight blood sugar control is necessary.

The patient has to be monitored closely for episodes of glucose highs and lows and the medication/insulin needs to be adjusted.

Persistent high glucose is an effect of infection and can also delay recovery. Side effects of drugs need to be managed eg., steroids increase blood glucose, deplete vitamin D, and increase hunger pangs.

A diet planned by an expert who manages Covid cases will help tackle complications and avoid weight gain.

(The author is a dietician & nutritionist.)