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Review Article (Pages: 313-321)
Food and Nutrition in Relation to the Prevention and Treatment
of COVID-19: A Review
1 2 3 4
Abolfazl Fattah , Sara Saadat , Fatemeh Sistanian , Mohaddeseh Badpeyma , Farzaneh
5 6 71
Fazeli , Benyamin Fazli , *Hamed Azadi
1Velayat Hospital, Semnan University of Medical Sciences, Semnan, Iran. 2 Pediatric Nephrologist, Department
3
of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Department of
Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. 4Student Research
Committee, Department of Clinical Nutrition, Nutrition Research Center, School of Nutrition and Food
Sciences, Tabriz University Of Medical Sciences, Tabriz, Iran. 5Assistant Professor of Intensive Care Medicine,
North Khorasan University of Medical Sciences, Bojnord, Iran. 6Assistant Professor of Intensive
Care Medicine, Department of Anesthesiology, Mashhad University of Medical Sciences, Mashhad, Iran.
7Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.
Abstract
Due to the lack of definitive treatment for COVID-19 so far, there is an urgent need to find
alternative methods to control the spread of the disease. This study aimed to review available
information on food and nutrition in relation to the prevention and treatment of COVID-19 from
various sources. The studies showed that feeding during an illness is different from feeding at normal
times. During an illness, in addition to meeting daily needs, attention should be paid to the changes
caused by the disease in the body. These changes include loss of appetite, decreased sense of smell
and taste, inability to chew and swallow, weakness, reluctance to eat certain foods, and other changes
depending on the severity and duration of the illness. Therefore, in patients' nutrition, the patient's
condition should be examined and their diet should be prepared according to their condition. Both in
normal and emergency situations, it is necessary to observe balance and variety in the consumption of
all foods. There was no information available on the association between diet and COVID-19.
The best diet recommended for patients with COVID-19 is a soft, high-protein, high-calorie diet. It is
recommended to use water, juices, teas, and soups at the beginning of the symptoms. Getting all the
necessary vitamins helps increase the level of immunity and fight disease and recovery through its
food sources, and food sources containing vitamins and minerals have no precedence over each other.
Nevertheless, given the lack of randomized controlled clinical trials of any treatment against COVID-
19, medical providers have to utilize therapeutic approaches based on past, often outdated, research.
Key Words: COVID-19, Nutrition, Prevention, Treatment.
*Please cite this article as: Fattah A, Saadat S, Sistanian F, Badpeyma M, Fazeli F, Fazli B, et al. Food and
Nutrition in Relation to the Prevention and Treatment of COVID-19: A Review. Med Edu Bull 2021; 2(4): 319-
27. DOI: 10.22034/MEB.2021.317807.1038
*Corresponding Author:
Hamed Azadi, Faculty of Paramedical Sciences, Ilam University of Medical Sciences, Ilam, Iran.
Email: Ha.azadi1370@yahoo.com
Received date: Aug. 10, 2021; Accepted date: Nov.22, 2021
Med Edu Bull, Vol.2, N.4, Serial No.6, Dec. 2021 313
Nutrition and COVID-19
1- INTRODUCTION The spectrum of disease ranges from mild
Coronavirus disease 2019 (COVID- to severe and the symptoms include colds,
19) is a contagious disease caused fever, cough, shortness of breath, and other
by severe acute respiratory syndrome respiratory problems. All age groups can
coronavirus 2 (SARS-CoV-2). The first be affected by the virus, but seniors and
known case was identified people with cardiovascular diseases,
in Wuhan, China, in December 2019 (1, hypertension, diabetes, asthma,
2). The disease has since spread respiratory, kidney, and liver problems,
worldwide, leading to an ongoing cancer patients undergoing treatment,
pandemic (3). The COVID-19 outbreak, patients taking corticosteroids for any
one of the most challenging threats to reason, and people with a weak immune
public health at the national and system are at higher risk for coronavirus
international levels since December 2019 (10, 11). Therefore, it is of utmost
(4-7), has caused tension and fundamental importance to provide care for and prevent
changes in the daily lives of many people infection in these people. Considering the
worldwide, especially students. complications of coronavirus infection, it
Due to the lack of definitive treatment for is necessary to know useful nutrients to
prevent and control COVID-19 disease.
COVID-19 infection so far, there is an According to recent studies, proper diet
urgent need to find alternative methods to and correction of immune-related nutrient
control the spread of the disease. Nutrient deficiencies may be necessary to prevent
deficiencies lead to a decrease in the and treat viral infections (8). The present
function of the immune system, which in study aimed to review the latest studies on
turn can make the body more vulnerable to effective nutritional recommendations for
viral infections. The human immune the prevention, treatment, and management
system is a complex and efficient defense of COVID-19.
system consisting of cells, chemical
mediators, and a series of "modular" 2- MATERIALS AND METHODS
defense factors to modulate the immune 2-1. Data sources
response and protect the body against
external factors (8). In this review study, a systemic
Malnutrition weakens the immune system search of electronic databases of Medline
by suppressing it. A balanced diet, (via PubMed), Scopus, Web of Science,
especially with adequate vitamins, ProQuest, Cochrane Library, SID,
minerals, and proteins, strengthens the Magiran, CIVILICA, and Google Scholar
resistance to infections, therefore ensuring search engine was performed with no time
proper nutrition. Eliminating immune- limit up to August 2021, using the
related nutrient deficiencies is essential for following keywords alone or in
the prevention and treatment of viral combination: "Corona or Coronavirus or
infections. There are challenges against the COVID or COVID-19" AND "Nutrient or
general public in protecting the immune Vitamin supplements, or Vitamin or
system against the coronavirus. The Mineral or Macronutrient or Micronutrient
optimal immune response depends on the or Nutritional care management or Pre-
adequate intake of certain nutrients. For existing diseases".
example, adequate protein intake is critical The studies were in English or Persian
to the optimal production of antibodies. languages. The search was done
The deficiency of micro-nutrient, such as independently and in duplication by two
vitamin A or zinc, can increase the risk of reviewers, and any disagreement between
infection (9).
Med Edu Bull, Vol.2, N.4, Serial No.6, Dec. 2021 314
Fattah et al.
the reviews was resolved by the 3-1. Principles of nutrition in the
supervisor. prevention of COVID-19
2-2. Inclusion and exclusion criteria Proper nutrition and strengthening the
All descriptive, interventional, and case immune system can help prevent disease.
studies in English or Persian were included Adherence to instructions will help
in the study. Exclusion criteria were increase the body's immune system under
animal samples and lack of access to specific situations:
required statistical data. To increase the level of body
2-3. Study selection immunity, sources of vitamin C should be
used, including fruits and vegetables,
The database was searched for suitable especially green leafy vegetables and
studies, abstracts of the studies were cabbage, cauliflower, tomatoes, wheat
screened for identification of eligible germ, citrus fruits, kiwi, and other
studies, full-text articles were obtained and available fruits on a daily basis.
assessed, and a final list of eligible studies As uncooked onion contains
was made. This process was done vitamin C, it can be used daily along with
independently and in duplication by two meals.
reviewers, and any disagreement was Turnips, which contain vitamin C,
resolved by a third reviewer. References
were organized and managed using can be used in soups or stews.
EndNote software (version X8). Considering the role of vitamins A
3- RESULTS and E in strengthening the immune system,
sources of these two vitamins should be
Experts indicate that under both used on a daily basis.
normal and emergency situations, it is Fatty and salty foods such as salty
necessary to observe balance and variety in snacks, canned foods and sausages, oily
a diet. Balance means consuming and fried foods should be avoided since
sufficient foods to maintain the body they stimulate the immune system.
health, and variety refers to consuming Foods rich in vitamin D (fatty fish,
different types of nutrients based on the dairy, and egg yolk) help boost the
Iranian food pyramid in six main food immune system.
groups (bread and cereals, vegetables,
fruits, milk and dairy products, meat and Sources of iron and zinc (liver, red
eggs, and legumes and nuts). Nutrients in meat, chicken and fish, eggs, vegetables,
each food group have almost the same fresh and dried fruits, nuts and legumes)
nutritional value and can be replaced with should be taken on a daily basis.
each other. Adequate nutrient intake Sources of B vitamins such as
improves the immune system and green leafy vegetables and fruits, milk and
strengthens the body’s resistance to dairy products, meats and egg yolk, whole
various infections, particularly COVID-19. grains, legumes such as peas and beans,
Micronutrient deficiency can weaken the lentils, fava beans, and nuts (pistachios,
immune system and reduce the body's walnuts, hazelnuts, almonds, and peanuts)
ability to fight pathogens (11-19). Some should be taken to boost the immune
essential nutrients, as well as nutritional system on a daily basis.
recommendations for COVID-19
prevention, during the disease period and
after recovery, are provided below.
Med Edu Bull, Vol.2, N.4, Serial No.6, Dec. 2021 315
Nutrition and COVID-19
It is recommended to drink six to measure is the adequate intake of essential
eight glasses of clean drinking water or micronutrients for the immune system
other liquids daily. such as vitamins C, B6, E, D, zinc,
Drinking plenty of fluids helps magnesium, selenium, and omega-3,
maintain a healthy immune system. especially from food sources rich in these
compounds. Immune system cells, for
Eating out should be avoided. example, are rich in vitamin C, and the
Outdoor meals may not be prepared based supply of vitamin C to the affected cells
on proper hygiene and have high amounts increases under stressful conditions, which
of saturated and Trans fat and salt, which in turn increases the need for vitamin C
weaken the immune system. during infection and inflammation. Experts
3-2. Nutrition during the COVID-19 believe that vitamin C plays an important
pandemic role in strengthening the immune system
and preventing and controlling the disease.
Nutrition during the COVID-19 pandemic 3-3. Nutrition after recovery from
should be different from normal COVID-19
conditions. In this period, in addition to
meeting daily needs, disease-related body Following the infection, patients lose
changes should be considered, including appetite while requiring more nutrients.
loss of appetite, decreased or loss of sense Therefore, the patient may suffer from
of smell and taste, inability to chew and malnutrition. During the recovery period,
swallow, physical weakness, reluctance to the appetite increases and there is time to
eat certain foods, and other changes compensate for the nutrient deficiencies
depending on the severity and duration of and an appropriate diet can be planned to
the disease. Therefore, the patient's meet nutritional needs during the recovery
condition should be examined and their period.
diet plan should be prepared accordingly.
Although it is best to plan the patient's diet 3-3-1. Recommendations for the diet of
by a nutritionist, general advice to patients people who are recovering from
can be helpful in the absence of nutrition COVID-19 disease:
and diet counseling services. This section Supplying large amounts of fluids
provides general recommendations such as clean drinking water, natural fruit
regarding the nutrition of COVID-19 juices, fresh vegetable juices, and light tea
patients. at least eight glasses per day.
The most recommended diet for COVID- Warm, light, and non-bloating
19 patients is a soft, high-protein, high- soups.
calorie diet. However, this diet is planned
for patients who can chew and swallow, Daily consumption of fresh fruits
and special diets are used for critically-ill and vegetables.
patients. In general, drinking enough fluids Use of food sources of vitamin A
is an effective step in controlling the and vitamin C.
disease. Water, juices, teas, and soups are Use of food sources containing
recommended fluids at the onset of protein, zinc, iron, and selenium, which
symptoms. Digestion of liquid compounds strengthen the immune system.
requires less energy, so the body will have
more energy to fight disease. Fluids help Use of liquid vegetable oils instead
dilute secretions and eliminate toxins and of animal oils.
relieve sore throats. Another important
Med Edu Bull, Vol.2, N.4, Serial No.6, Dec. 2021 316
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