As with many illnesses, good nutrition plays an important role to speed recovery from COVID-19. Smart food choices help to provide the proper anti-inflammatory nutrients needed to support essential bodily processes, improve immunity, and protect against loss of energy and diminished muscular strength.
Both macro- and micronutrients are key drivers for a healthy immune response, particularly for higher-risk populations.
Even for those who have not been diagnosed with COVID-19, poor nutrition can compromise immune function and increase the risk of becoming infected. Here is a look at how important it is to educate home-based care providers on nutritional support principles, along with the top tips needed to make sure patients with COVID-19 stay as healthy and strong as possible, as outlined by Certified Nutrition Support Clinician, Lisa Logan of McKesson Medical-Surgical.
Fluids: 2-3 liters per day
It is critical that patients stay hydrated, Logan says. Fluid requirements must be individualized based on a range of factors, including body weight, age, gender, medical conditions and body temperature. According to American Society of Parenteral and Enteral Nutrition, patients should drink water or clear liquids every hour. Ideally, they should consume at least two to four ounces of fluid every 15 minutes. If the patient has gastrointestinal issues, such as vomiting or diarrhea, then he or she must consume oral hydration solutions along with water.
“The important thing is to monitor seniors for signs of dehydration,” Logan says. Signs of dehydration can include increased thirst, fever, dizziness, lightheadedness, decreased urine output, dark colored urine color and an increased heart rate.
Logan has four sample recommendations for caregivers:
– Keep liquids visibly available for patients, including at the bedside
– Offer a variety of liquids to avoid taste fatigue
– Remember to include foods with a high fluid content, such as melons, soups and stews
– Select the appropriate liquid supplement as recommended by a registered dietitian who understands the patient’s medical conditions
“The type of liquid you drink will depend on the situation,” Logan says. “Water or clear liquid drinks with electrolytes are fine. But there are many patients who are malnourished and would benefit from a high-calorie, high-protein supplement if they have a diagnosis of malnutrition. The drink selected should be based upon a clinical evaluation and assessment.”
Calories: 1,500 to 2,000 calories daily — normal maintenance
Due to increased stress from COVID-19, an individual often needs an additional 400 to 500 calories each day, over their normal dietary requirements. In some cases, home-based care providers should aim for patients to consume between 2,000 and 2,500 calories per day. Utilizing the expertise of a dietitian can help formulate a diet plan with high calorie and high protein supplements, so that patients can achieve their nutritional goals.
Along with the calorie count, seniors must focus on an anti-inflammatory diet.
“COVID is an inflammatory process and improper dietary choices can adversely impact the immune system,” Logan says. “Therefore, consuming an anti-inflammatory diet is essential. You want more of a plant-based diet, eliminating refined foods, sugar, saturated fats and processed meat. The food that you give your loved one, or a patient, should be healthy.”
Protein: 75 to 100 grams per day
One major focus for caregivers helping patients with COVID-19 is addressing malnutrition.
“Malnutrition is a risk factor causing many issues relating to functional and physiologic decline, along with organ dysfunction that leads to increased rates of morbidity and mortality,” Logan says. “There is emerging evidence that one’s nutritional status clearly impacts immunity. If your immune system is not up to par, you can’t fight off infection. It is important to identify malnutrition early on so that nutrition support can be implemented immediately to improve health and quality of life.”
To avoid malnutrition, caregivers should use a reliable malnutrition screening tool, one that provides a score to address the severity of malnutrition. The MNA (Mini Nutrition Assessment) by Nestlé Nutrition Institute is an example of a tool that clinicians can use. It addresses key factors such as recent weight loss, appetite and body mass index to help determine the degree of nutritional impairments.
The caregiver must also encourage a diet that is adequate in protein, which is required to maintain muscle mass. Most patients require at least one gram of protein per kilogram of ideal body weight, which can total 75 to 100 grams of protein per day.
While requirements will vary with conditions such as kidney and liver disease, some standard protein sources include:
– Peanut or nut butters
– Dairy (milk, eggs, yogurt, cheese)
– Meat (fish, poultry)
– Protein shakes
However, one should consider getting dietary protein from plant- based alternatives like soy products (tofu, tempeh, and edamame), lentils, chickpeas, almonds and Quinoa.
Supplements for immunity boost
Along with promoting protein and high calorie diets, liquid supplements taken between meals can provide an extra immunity boost and maintain the flow of nutrients into the body. Logan cites the work of Dr. Gina Serraiocco, who recommends a variety of supplements that can help the immune function, so it is more equipped to fight inflammation.
“Patients who are vitamin D-deficient have a higher chance of getting COVID,” Logan says.
She adds that zinc, vitamin C, melatonin, turmeric and Omega-3 fatty acids can all serve as anti-inflammatory and immune-supportive agents. For many of these recommendations, Logan credits Dr. Serraiocco, an integrative and functional medicine physician at Sutter’s Palo Alto Medical Center, whose research is industry-leading in this area. Dr. Serraiocco has made it her focus to educate patients and health care workers on the best life-style approaches and supplements needed to help during this horrible pandemic.
This article is sponsored by McKesson Medical-Surgical, which works with health systems, physician offices, extended care providers, in-home patients, labs, payers and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting. For more information, visit mms.mckesson.com.
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