Long Covid and diet

Following a coronavirus (COVID-19) infection, symptoms can last for more than 12 weeks, this is called Long COVID. Symptoms vary widely, affecting different body systems. Long COVID does not seem linked to how ill you were initially, and most people improve over time. Some people recover completely whilst others will experience ongoing fluctuating symptoms.

Common symptoms include:

• extreme tiredness (fatigue)
• memory and concentration problems (“brain fog”)
• gastrointestinal issues
• shortness of breath
• chest pain
• sleep difficulties
• joint pain

Check ongoing symptoms with your doctor to rule out other causes. Many of these can affect your ability to eat well.

How can I eat well with Long COVID?

Your body needs a balance of vitamins, minerals, protein, fibre, energy and fluids to help you recover. Having plenty of these things  supports muscle rebuilding, immunity (being resistant to a particular infectious disease) and energy. Following a Mediterranean-style diet and the NHS Eatwell Guide is recommended.

• Base meals on starchy carbohydrates, ideally wholegrain, which is good for fibre and often releases energy more slowly
• Aim for five portions of fruit and vegetables daily. Ideally this should be a variety of different types and colours.
• Include beans, pulses, nuts, seeds, fish, eggs and meat for protein. Limit red and processed meats.
• Eat fish twice a week, especially oily types which are rich in omega-3. Plant based sources of omega-3 include nuts and seeds like walnuts, pumpkin seeds, chia seeds and vegetable oils, soya milk and tofu.
• Dairy or fortified plant-based drinks provide protein and calcium.
• Use small amounts of unsaturated oils and spreads.
• Drink around two litres a day but limit fruit juice/smoothies to 150ml daily. More information can be found in our Fluid (water and drinks) Food Fact Sheet.

How can I manage my Long COVID symptoms?

Smell/taste changes: Using strong flavours such as spices, or sharp and bitter tastes like citrus may help. Varying textures of food keeps eating interesting. You might also prefer food to be served cold or at room temperature. 

Advice in this area depends on your symptoms but you can get further support and resources on living with taste or smell loss, by visiting this website. You can find more information on smell testing and training here.

Gut health: Long COVID can cause IBS-type symptoms, like an upset stomach, but you should rule out other causes with your doctor. Gut bacteria play a role in our health. To improve gut health, eat a diverse range of fruits, vegetables, wholegrains, beans, nuts and seeds. There is evidence that probiotics, may help some people with Long COVID-related gut symptoms. Stress, anxiety and poor sleep can negatively impact gut health, so you may find having some psychological or talking therapies helpful too.

Poor appetite or unintentional weight loss: Try smaller meals more often, with nourishing snacks and milk-based drinks. If you are struggling with tiredness, choose ready-made options. For more ideas on how to make the most of your food take a look at this leaftlet.

Unintentional weight gain: Weight gain is common during Long COVID due to fatigue, which can make daily activities challenging. Continue to eat regularly to help provide your body with the nutrition it needs. Check you are eating foods from all the food groups. Try to listen to your body when it tells you it is full to reduce overeating, this is known as intuitive eating.

Do supplements help?

A vitamin D supplement (10 micrograms daily) is recommended for all UK adults from October until April or all year-round if you are indoors most of the time, usually wear clothes that cover your skin when outside or have dark skin. Find out more in our Vitamin D Food Fact Sheet.

If you unable to eat a varied diet, consider a standard A-Z multivitamin. High doses of individual vitamins (e.g. magnesium, vitamin C, zinc) are not recommended, as evidence is lacking and they may be harmful.

Does a low histamine diet help symptoms?

Some people with Long COVID may be sensitive to histamine in food. There isn’t enough evidence to show that a low histamine diet helps alleviate this sensitivity though.

A low histamine diet is restrictive, time-consuming and complex. The Mediterranean diet is healthier and easier to follow.

How can a dietitian help me with Long COVID?

Ask your GP for a dietitian referral if you are:

• unable to eat well due to your symptoms
• following a restrictive diet
• losing or gaining significant amounts of weight unintentionally

Private dietitians can be found via the BDA Freelance Directory.

Top tips

1. Plan, if possible, for easy quick snacks, meals and nourishing drinks.
2. Eat regularly - three meals a day plus snacks, if needed.
3. Avoid restrictive diets as they can make it difficult to meet your nutritional needs.
4. Aim for a Mediterranean-style diet, including a diverse range of plant-rich food.
5. Check for any unwanted weight changes - aim to keep a steady healthy weight.
6. Be kind to yourself. Eating can be difficult when you are unwell. Small changes often work best.