16 Mar 2020

Last updated August 11 2020

Dietitians and the BDA have been asked many questions about nutrition and dietary issues related to the COVID-19 / Coronavirus pandemic.

We would always encourage members of the public to start by following the latest advice from governments, the NHS and public health authorities. It is important to note that guidance differs in England, Scotland, Wales and Northern Ireland. You can find more information here;

In all cases, if you or someone you live with have COVID-19 symptoms, you should stay at home

If you have more specific concerns, please visit or call NHS 111 (NHS 24 in Scotland, NHS 111 in Wales or call 111 in NI) or contact your local health services in a safe and appropriate manner online or by phone. If you have a serious health issue, it is important that you still seek medical help. If you have a medical emergency, dial 999. 

We have also created the following Frequently Asked Questions, which we will update and add to on a regular basis.

Supplements

Can I boost my immune system through my diet?

Simply put, you cannot “boost” your immune system through diet, and no specific food or supplement will prevent you catching COVID-19/Coronavirus. Good hygiene practice remains the best means of avoiding infection.

To date, the European Food Safety Authority have not authorised any claim for a food or food component in the UK to be labelled as protecting against infection. More info here.

There are many nutrients that are involved with the normal functioning of the immune system, so we would encourage maintaining a health balanced diet in order to support immune function (include copper, folate, iron, selenium, zinc and vitamins A, B6, B12, C and D). We don't recommend any one food over another, but instead encourage eating a variety of foods to maintain a health balanced diet. See our Healthy Eating Food Fact Sheet for more tips and guidance on how to do that.

Our Older People Specialist Group and the Rooted Project created an infographic you can share

Should I take a vitamin D supplement?

Vitamin D works with calcium and phosphorus for healthy bones, muscles and teeth. It is also important in protecting muscle strength and preventing rickets, osteomalacia and falls.

In normal circumstances, sunshine, not food, is where most of your vitamin D comes from. So even a healthy, well-balanced diet, that provides all the other vitamins and nutrients you need, is unlikely to provide enough vitamin D if you aren't able to get enough sun. During autumn and winter months when we spend more time indoors and the sun is weaker, adults and children over the age of one are advised to take a daily supplement containing 10 micrograms of Vitamin D.

Now we are in summer, if you can, you should seek to spend some time outdoors in the sunshine (e.g. your garden or balcony). However, if you are having to self isolate or if you are unable to go outside, you should consider taking a daily supplement containing 10 micrograms to ensure a healthy vitamin D status (for adults and children over the age of one).

All babies under one year should be given a daily supplement of 8.5-10 micrograms unless they have more than 500mls of fortified formula milk.

You can also eat plenty of vitamin D rich foods, including:

  • Oily fish such as salmon, sardines, pilchards, trout, herring, kippers and eel contain reasonable amounts of vitamin D.
  • Cod liver oil contains a lot of vitamin D, but don’t take this if you are pregnant.
  • Egg yolk, meat, offal and milk contain small amounts, but this varies during the seasons.
  • Margarine, some breakfast cereals, infant formula and some yoghurts have added vitamin D.

Find out more in our Vitamin D Food Fact Sheet.

General

What general nutrition advice would you give for an someone who may have contracted COVID-19 and is self-isolating as a result?

If you feel you cannot cope with your symptoms at home, your condition is worsening or you have had symptoms for more than seven days, visit NHS 111. Do not go to a GP, pharmacy or hospital unless told to do so.

If you are self-isolating and especially if you have symptoms, it is important to maintain good nutrition and hydration. Make sure you are eating and drinking regularly, even if you have low appetite.

If you are in an at risk group or you are concerned about someone who is, please read some of our more detailed questions below. 

If you have specific nutrition needs, it is important that you continue to follow the dietary recommendations made by your dietitian or other healthcare professional. This may involve asking friends or family members to get you specific foods so you can continue to follow an appropriate diet.

Contact your dietitian or other healthcare professional in a safe way if you have concerns.

How can I make best use of the food I buy?

We’ve also got some tips from our Food Services Specialist Group to help you plan your shop and how to make best use of the food that you buy:

  • Use up your fresh ingredients first. You don’t want any food to go to waste, so use up perishable ingredients before foods with a longer shelf life.
  • Know what keeps longest. Fresh foods with relatively long shelf life includes root vegetables such as potatoes, sweet potatoes, carrots, onions
  • Carefully wash, rinse and drain salad leaves and fresh herbs and spin dry in a salad spinner, place into a suitable plastic storage tray, cover and keep refrigerated. By following this procedure your salads and fresh herbs will last for several more days than if just stored in the fridge un-covered.
  • It might seem obvious but make sure you aren’t storing things in your fridge that don’t need to be in there. For example, fresh tomatoes, un-peeled onions, un-peeled jacket potatoes, whole butternut squashes don’t need to be stored refrigerated. Removing these items from your fridge and storing them in a cool dark place will free up fridge space for more perishable items.
  • If you are stuck at home, take the opportunity to tidy and declutter your kitchen cupboards to free up space for ambient food products.  This is a great opportunity to get rid of those unused & unwanted items that end up “living” in your valuable storage space. Remember to re-cycle as many of the items you are discarding as possible.
  • If you do get sick, it is worth having a few easy to cook and prepare foods in the house on standby. Canned soups, microwavable rice and frozen ready meals are easy options that you can keep in stock in reasonable quantities if you don’t have the energy to prepare more complex recipes.

If you’re looking for recipe ideas or more advice on cooking and food preparation, our Let’s Get Cooking programme have some great advice.

Our Eat Well, Spend Less fact sheet can help you eat well on a budget

Love Food Hate Waste have some fantastic advice on what you can do to minimise your waste.

Should I be concerned about food safety and COVID-19 transmission?

It is very unlikely that you can catch coronavirus from food. COVID-19 is a respiratory illness. It is not known to be transmitted by exposure to food or food packaging.

Please continue to follow general food safety advice; washing hands thoroughly, cleaning surfaces and separating raw meat/fish from other foods when preparing food. 

Public Health England have published guidance on COVID-19 for food businesses which should be followed to minimise the risk of infection from employees. 

The Food Standards Agency have also published advice if you are preparing or supplying food to food banks or vulnerable people

What should I do if I'm worried about COVID-19? What about my mental health?

It is understandable that many people will feel anxious or upset about the COVID-19 outbreak and the impact that it has on their lives. This is a stressful time even as lockdown is lifting and looking after your mental as well as your physical health is important.

Our colleagues at MIND have some great resources to help, including on planning for self isolation, looking after mental wellbeing and accessing further support. 

Public Health England have also published advice on mental health and wellbeing. Key tips include:

  • Keep connected
  • Support and help others
  • Look after your sleep
  • Manage difficult feelings and talk to others
  • Get the facts

You can also read our Food and Mood Fact Sheet to consider how your diet impacts your mental health. 

What other steps can I take to stay well when social distancing?

Professor Rachel Batterham from the RCP has developed a series of videos (featuring dietitian Dr Adrian Brown!) which show how people of different ages and abilities can stay fit and healthy even while staying at home. Take a look:

  1. Older adults, or people who are less active: https://youtu.be/8Frf1EjnZ_Y
  2. Active adults: https://youtu.be/S6dD0A7M8wY
  3. Children and young people: https://youtu.be/U9W9RJpQ7cY

Malnutrition

Why is malnutrition important to consider for COVID-19?

Malnutrition is known to be a risk for those that have had COVID-19 and are recovering. Many people who fall into the at-risk group and who may have been isolating for some months, are also those considered to be at greater risk of malnutrition.

Malnutrition is a serious condition which can increase a person’s risk of infection as well as slowing down their recovery. Those with an infection are also at higher risk of developing malnutrition which slows their recovery.

Malnutrition is also more common for older people and those who are already socially isolated. Social distancing and social isolation could impact a person’s access to the wide variety of foods needed to keep healthy and may make them want to eat less.

Malnutrition can also increase the risk of frailty, which is also more common in older age. Frailty can lead to weaker muscles and make people more vulnerable to infections, falls and needing extra care. 

Unintentional weight loss due to disease or infection is not good, whatever someone’s original body weight was. Healthy eating in older age may look different to the general healthy eating guidelines. This is because older people are more at risk of malnutrition. Some older people may need reassuring that their diet should be different. 

Read our Malnutrition Food Fact Sheet for more info. 

How can someone who has had COVID-19 avoid malnutrition and ensure they are eating enough?

Dietitians can support you to recover and rehabilitate from COVID-19. If you have had COVID-19 and expecially if you have been in hospital, you may have lost weight, your appetite or have difficulties swallowing. Ensuring you are eating and drinking enough will be really important. Contact your GP or local dietetic team in a safe way if you think you might need support. 

For more advice on recovering after COVID-19 and ensuring good nutritional intake, we have the following advice:

How do I know if I or the person I care for is at risk of malnutrition?

Individuals (or their family member or friends) can self-identify whether they need nutritional help or extra nourishment here.

Health and Social care staff are recommended to screen at risk groups using the malnutrition universal screening tool (‘MUST’).

If you are unable to weigh someone due to self-isolation measures then the two part nutrition checklist can be used to guide and support action found at the bottom of this link.

Care Home staff are recommended to continue screening their residents for malnutrition using ‘MUST’.

What is the advice for someone at risk of malnutrition?

Our Malnutrition Food Fact Sheet has lots of information and advice on preventing and treating malnutrition, including a nutrient dense diet. 

It is important older people are still encouraged to keep active. Ideas for useful activity, including those that can be done at home, can be found here. Good nutrition, including eating enough protein, is essential to protect people’s muscles including respiratory muscles to help with breathing.  

Vitamin D can also help protect our muscles and taking a 10 microgram supplement each day (which can be purchased from any pharmacy or supermarket) is also advised for the winter months, people who are housebound and those not receiving much daylight. Find lots more tips and information in our Vitamin D Food Fact Sheet

Getting enough fluid is essential for good health, and you will need more fluid than usual is you have an infection. Adults are usually advised to have 6-8 mugs or large glasses a day, but this may need to be higher for someone with a high temperature. See our Fluid Food Fact Sheet for more information about how to get the fluid you need.

Our Older People Specialist Group and the Rooted Project have created an infographic with eight top tips on helping keep older people well that you can download here

For more information on practical tips for those at risk of malnutrition whilst self-isolating, please see this leaflet written by Bournemouth University (in collaboration with Wessex AHSN and the Malnutrition Task Force).

Health Conditions

What should I do if I'm living with Diabetes?

Our colleagues at Diabetes UK have produced an excellent resource answering lots of questions for people living with both type 1 and type 2 diabetes which we would recommend you read. 

If you have serious concerns about your diabetes, please contact your GP, consultant or dietitian. Help is still available.

What should I do if I'm living with Coeliac Disease?

If you have Coeliac Disease, it is important that you continue to maintain a gluten free diet even during social distancing or if you have to isolate as a result of symptoms.

Our colleagues at Coeliac UK also have some further excellent advice which we would encourage you to read. 

What if I have an existing respiratory disorder?

This leaflet produced by Royal Devon & Exeter NHS Foundation Trust is designed to support you to eat well and avoid unplanned weight loss. It includes information on meal planning, food fortification and has specific diet recommendation.

What should I do if I'm living with Crohn's Disease or Ulcerative Colitis?

If you have Crohn's or Colitis and are following a recommended diet, you should continue to do so. 

Our colleagues at Crohn's and Colitis UK have some excellent advice that we would recommend you read.

What should I do if I or my child has food allergies?

It remains important that you maintain any diet recommended for you or your child by a dietitian or healthcare professional. If you or your child has a serious allergic reaction, contact health services as you normally would - help is still available. 

For further information we have the following resources:

If your child uses specialist formulas, please see our FAQ below on this topic under “Pregnancy and Babies”

 

What should I do if I am living with IBS?

If you have IBS, you may be worried about the impact of COVID-19 and social isolation. Dietitians Kirsten Jackson has written a blog post for the BDA Freelance Dietitian website about IBS and coronoavirus which you can read here.

Kirsten has also developed a free webinar for those living with IBS, which considers anxiety, how to structure your day and dietary consideration. Access the webinar by clicking here

Where can I access more expert advice on diet and health conditions?

The fantastic Patient Webinars series by Somerset NHS Dietitians are a series of free to access, patient-focused webinars on a range of topics. This means you can access advice without needing to see a dietitian face-to-face. 

Topics/conditions covered include:

  • Advice for Children
  • Coeliac Disease
  • Constipation
  • Diabetes
  • Adult Food Allergy
  • Inflammatory Bowel Disease
  • Irritable Bowel Syndrome
  • Kidney Health
  • Malnutrition

 


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