Nutrition for COVID-19 Patients with Comorbidities

For individuals suffering from chronic conditions, preconditions, overweight or obesity and elderly we recommend a personalized nutrition plan. General diet plans do not address their nutritional needs adequately. In COVID-19 patients the presence of such comorbidities is a significant concern and the nutritional status of these patients is undeniably a worry.

Patients with comorbidities who are already infected could follow a personalized anti-inflammatory diet and potentially avoid serious illness due to COVID-19. These dietary patterns contain nutrients that impart anti-inflammatory and immunomodulatory properties on patients with non-communicable diseases without suppressing the immune system.

General guidelines for individuals with comorbidities

• Get your vaccination done if you haven’t already done so. Vaccination does not ensure 100% protection from mutated versions of the virus. So strictly follow social distancing and hand hygiene even after vaccination.
• Continue your prescribed medication and consult your physician on a regular basis.
• Do not consume supplements without consulting your physician or dietitian. Consumption of supplements in excess could compromise your immune system.
• If possible get a personalized diet plan from a clinical dietitian or other qualified healthcare provider.
• Even though not always possible, moderate exercise such as walking indoors or within a secured area is beneficial in supporting immune health.
• Consume fluids regularly as there could be huge loss of bodily fluids due to infection.
• Keep yourselves stress free and follow a normal sleep cycle.
• Do not follow or share any pseudoscience and misinformation surrounding potential treatments to fight the COVID-19 infection. Contact your physician or qualified healthcare providers to verify any information.

For individuals with diabetes, prediabetes and insulin resistance

• High blood sugar increases the severity of COVID-19 infection.
• Individuals with diabetes should try to manage their blood glucose level within the target range of 70 to 180 mg/dL.
• Individuals with prediabetes and insulin resistance should try to manage their blood glucose level within the target range of 70 to 140 mg/dL.
• If possible these patients are recommended to use a continuous glucose monitoring device along with a personalized diet plan.
• Do not skip or change the dosage of diabetic medications and ensure to have a good supply.
• Initiation of steroid therapy affects the glycemic control and causes hyperglycemia hence blood glucose levels have to be monitored at regular intervals¹.

For individuals with hypertension and cardiovascular disease

• Keep taking your high blood pressure medication as prescribed.
• Continue monitoring your blood pressure regularly.
• Follow a healthy dietary pattern. Consume a diet rich in fruits, vegetables, whole grains, and low-fat dairy products, with reduced content of saturated and total fat.
• Reduce the intake of foods high in salt and fats.

For individuals with respiratory diseases

• Right balance of nutrients in the diet is essential for easier breathing.
• Oxygen and food are the raw materials in the process of metabolism, whereas carbon dioxide and energy are the end products. Carbohydrates utilize large amounts of oxygen and produce excessive carbon dioxide.
• Include complex carbohydrates and reduce simple sugars from diet to reduce the oxygen load.
• Include good quality proteins such as eggs, fish, chicken, nuts, legumes to maintain strong respiratory muscle.
• Including excess salt in the diet causes oedema and makes breathing difficult, hence salt intake has to be limited.
• Avoid foods that cause gas and bloating as they make breathing difficult.
• Have 4-6 meals instead of large and heavy meals to avoid respiratory distress².

For overweight or obese individuals

• Eating a healthy diet with lean protein, plenty of fruits and vegetables, whole grains appropriate in calories helps to reduce the severity of infection.
• Physical movement should become an integral part of routine as it helps in weight reduction, improves sleep quality and boosts immune function.

For individuals with gastrointestinal disorders

• Regularity of meal timings is very important.
• Consuming excessive amounts of tea, coffee, herbal teas and spicy foods may trigger acid reflux and cause gastritis.
• A high calorie and high protein diet is essential to maintain metabolic functions, muscle mass, and body weight³.

For individuals with renal disorders

• Individuals with renal disorders should consume minimally processed natural or whole foods such as fruits, vegetables, rice, lean meats, and home-cooked meals instead of buying foods from restaurants or processed foods from the market.
• Focus on plant protein sources and aim to have 0.5-0.6 g/kg ideal body weight incase of non dialysis.
• Serum sodium and potassium levels should be regularly monitored.
• Milk and dairy products, legumes and high fat meats should be limited according to diet prescription.
• Optimal hydration is essential but for individuals on dialysis the fluid intake should be strictly monitored.
• For individuals on dialysis the protein intake has to be 1.0-1.2 g/kg ideal body weight⁴.

For individuals with liver disorders

• Avoid or minimize the intake of alcohol.
• Avoid raw and undercooked meats.
• Limit salt and foods that include salts.
• Avoid toxins as they can injure liver cells. Limit direct contact with toxins from cleaning and aerosol products, insecticides, chemicals, and additives.
• Don’t smoke⁵.
• Protein intake has to be 1-1.5g/kg ideal body weight.
• Have small and frequent meals at regular intervals and include a bedtime snack consisting of carbohydrates and protein.
• Cholesterol intake should be limited, as high cholesterol levels suppresses the immune function⁶.

For any questions or personal nutrition plans please contact us at +918886667634.

REFERENCES:

1. Deng F, Gao D, Ma X, et al. Corticosteroids in diabetes patients infected with COVID-19. Ir J Med Sci. 2021;190(1):29-31
2. American Lung Association
3. Aguila EJT, Cua IHY, Fontanilla JAC, Yabut VLM, Causing MFP. Gastrointestinal Manifestations of COVID-19: Impact on Nutrition Practices. Nutr Clin Pract. 2020 Oct;35(5):800-805.
4. Mafra, Denise et al. “Coronavirus Disease 2019: Quick Diet and Nutrition Guide for Patients With Chronic Kidney Disease.” Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation vol. 31,1 (2021): 39-42.
5. American Liver Foundation
6. Ioannou GN, Morrow OB, Connole ML, et al. Association between dietary nutri- ent composition and the incidence of cirrhosis or liver cancer in the United States population. Hepatology 2009;50:175–84.