Beenish Zohra, a practising dietician and a clinical nutritionist, tells Farzana Nisar that good food plays an important role in building the immune system in the pandemic.
KASHMIR LIFE (KL): How important is food and nutrition in times of health crisis like Covid-19?
BEENISH ZOHRA (BZ): It is said that we are what we eat. Although food cannot prevent one from getting infected by Covid19, it can play a vital role in building our immune response. Covid19 is harsh and lethal for patients with co-morbidities like diabetes, cardiac issues, hypertension etc. In such patients, diet is of utmost importance to have pre-existing issues under control.
KL: How does our daily diet affect our immune system?
BZ: Malnutrition impairs the production of immune cells, while a proper diet rich in all nutrients, multivitamins and antioxidants, increases the production of healthy immune cells and their response to infection. Adequate and appropriate nutrition is required for all cells to function optimally and this includes the cells in the immune system. Eating a varied diet helps to ensure that you receive all the nutrients and antioxidants, which are necessary for a healthy diet. This increases the immunity of the body to fight against infection.
KL: What would be an ideal diet chart for a Covid-19 patient?
BZ: Always prefer unprocessed foods, fibre-rich diet and fresh fruits and vegetables. Drink plenty of fluids as hydration is very important
Breakfast: Try to eat healthy carbs, which digest slowly and make you feel full for a longer time – include eggs, dairy, and dairy products. One should try not to consume food that has been labelled as “refined”.
Mid-morning: Consume foods rich in antioxidants or that helps to improve immunity like sprouts, lemon juice (freshly prepared), dry fruits like almonds, walnuts, pumpkin seeds, flax seeds, sesame or ground nuts. These can be consumed as such or one can make shakes and smoothies.
Lunch: This can be a complete meal that is healthy. One can go for soft boiled rice or Roti made up of multi-grains like wheat, barley, millets, ragi, etc. One can always combine it with a good amount of dal with some vegetables, a glass of buttermilk or curd. One should always opt for variety in food. If the symptoms are too strong one can also go for a quick khichdi with sautéed veggies.
Evening snacks: Traditionally our Noonchai will energize you again along with some light and healthy snacks like roasted Channa, boiled grams, or homemade Roti with a dollop of butter. One can also opt for soups, stocks made from mixed vegetables or meat or chicken broth.
Dinner: Do not overeat. One should always try to have an early dinner. Dinner can be light and highly nutritious like lunch. The ideal plate is one-half vegetables, a quarter protein, and a quarter starches, such as grains or starchy vegetables.
Hydration: Hydrate with enough water (3 to 4 litres) and soups. Avoid sugary drinks, coffee, and tea to a certain extent.
KL: What are the essential vitamins required during the period of recovery?
BZ: Vitamins A, D and C are essential for preventing free radical injury in cells and prevent oxidative damage. Other vitamins like B-complex, protein etc are an important part of a chemical reaction taking place in the body. So food rich in all essential components help in speedy recovery.
KL: Eating well is essential to aid in healing, but many Covid19 patients experience loss of appetite and taste. How do you collate this?
BZ: Altered sensory perception- loss of appetite and taste are very common during active Covid19 infection and later in the rehabilitation phase as well. It is a combined effect of disease and medications used to treat Covid19 along with psychological stress. The main focus should be on well-functioning senses and post-ingestion well-being. Meals should be frequent and in small portions. Diet should include food that stimulates appetite. Psychotherapy also plays an important role, as the patient should be less stressed and also explained the importance of diet in their recovery.
KL: After recovery, many Covid-19 patients complain about weight loss. What kind of diet would you suggest to people if they are trying to regain weight?
BZ: Usually in Covid patients there is significant protein loss and patients with severe disease and long hospitalization fail to cope up with the disease physically and psychologically. A high protein diet along with all essential vitamins and minerals is recommended. Eating small and frequent meals would help in recuperating. One should try to adopt a disciplined routine that ensures access to a variety of fruits and vegetables to help stay healthy.
KL: How would you address the nutritional needs of Covid19 patients with co-morbidities, especially diabetes?
BZ: Co-morbid conditions like diabetes in Covid19 patients complicate the conditions if not managed properly. Patients are put on steroids, which further elevates their blood glucose level. Proper diabetic diet and blood glucose monitoring is essential. Plenty of Fluids, low carbohydrates, high protein and fibre rich diet is recommended.
KL: Nearly everyone nowadays pops up vitamin C and Zinc pills. Do they really help with Covid?
BZ: Vitamin C and Zinc play a key role in maintaining the integrity and functioning of the immune system. They reduce cell damage and help in preventing secondary infections. Zinc has an immune-modulatory and anti-viral activity that makes it an important ingredient of Covid19 treatment and prevention. Recent researches have proved that foods rich in Vitamin C, like citrus fruits including oranges, kiwis, red pepper, tomatoes, mangoes, amla, strawberries, etc aid in speedy recovery of infected patients and also some rich sources of Zinc such as beef, chicken, seafood, whole grains, dairy and dairy products are helpful. Taking supplements leads to an increased level of total nutrient intake, and doctors can help people achieve a balance between nutrients from food and supplements.
KL: What kind of nutritional approach would you take to help children who are at the risk of contracting the infection?
BZ: As Covid19 symptoms in children are often mild and initially go undetected, it can result in more severe cough, fever, or breathlessness, in some cases. Children also can be silent carriers of Covid19. As far as the nutritional approach is concerned, parents should include colourful fruits and vegetables in the diet as they can provide a broad spectrum of essential nutrients and antioxidants to build immunity and ward off infections.
Also try to add foods rich in vitamin C like citrus fruits, foods rich in zinc, like whole grains, lentils, non-vegetarian foods, beans and nuts, in the diet. Adding milk and milk-based products like curd will help in maintaining good health, and food fortified with Vitamin D can be useful too. Avoiding junk, processed, canned, artificially preserved is very important. These can provide protection against viral infections be it seasonal or infection in times like these.
KL: Can home remedies help you fight the Coronavirus?
BZ: Home remedies can’t prevent you from an infection due to Covid19, but they can help you to prevent complications. Taking rest, drinking plenty of fluids, using nourishing food, hot beverages like kehwa, avoiding high sugar content and taking care of hygiene can help. Try eating meals 4-6 times a day, every 2-3 hours. Eat food even if you don’t feel hungry. It is important as the body is recuperating. Try to have a diet rich in good carbs (avoid refined Carbohydrates) a good amount of protein ( milk and milk products, lentils, non-vegetarian sources, eggs, nuts etc), seasonal fresh fruits and vegetables give nutritional add on such as dietary fibre, micronutrients, and antioxidants. They help to build immunity. Have 2-3 servings of fresh fruits and 3-4 servings of vegetables daily. Seasonal fruits like strawberries, guava, papaya, and other citrus fruits. Have green leafy vegetables, carrots, and gourd varieties in the diet.
KL: Talk something about stress or emotional overeating related to fear, sadness or boredom caused by the virus?
BZ: Sudden onset of pandemic, its infection and mortality rate along with impacts of lockdown and SOP’s have put fear in people’s minds. Infection with Covid19 followed by hospitalization in isolated condition away from families and friends with fear of dying alone has caused psychological trauma to patients and society as a whole. All these have lead to the prevalence of psychological symptoms, emotional disturbances, depression, stress, emotional exhaustion, anger and post-traumatic symptoms, which one can face not only during the infection phase but later on in the rehabilitation phase or maybe in future as well. We have to deal with it in a delicate manner. The pandemic should not trigger binge eating and mindless eating. One should always watch what he eats. Having proper and healthy meals on time would ward off unhealthy cravings and binge eating.