Introduction
As we all know the severe acute respiratory syndrome corona virus 2 (SARS-CoV 2) had been declared a global pandemic by World health Organization in year 2020.1, 2 The usual presentation might have cough, fever, myalgia and breathing difficulties. More severe cases might present with various multi system dysfunction, septic shock or cardiac complications. These complications were believed to be associated with cytokine storm, excess immune response and hyper inflammation.3
The government has implemented various policy and restrictions on physical movements to prevent further spread of the disease. This self-confinement has created stress, sedentary life style as well as affected the dietary habits in various ways such as changes in eating behavior, limited access to food, running out of staple items, perception of food safety, higher consumption of processed and package food with high caloric content, high saturated fats, sugars and refined carbohydrate levels. All these factors with sedentary life style might increase in obesity prevalence in community.2, 3, 4 So, the purpose of this article is to provide importance of nutrient supplements and prepare a sample diet chart which can prevent the obesity at certain extent with immune booster efficacy.
Discussion
According to an observational study, the nutritional status plays a pivotal role in the clinical outcomes of patients recovering from COVID-19, and that nutritional support along with rehabilitation may improve the chances of recovery in patients of COVID-19.5
The food habits and dietary behaviour have changed due to COVID 19 pandemic. An international online survey with 1047 participants from different continents has concluded increase in sitting time and reduction and physical activity during lockdown periods. It also proved that lockdown and isolation was associated with unhealthy dietary patterns with increase snacking between meals.6 Another study from France concluded that lockdown was related to decrease in the nutritional quality of food.7 The study from Poland has concluded significant dietary modification due to quarantine with increase snacking and weight changes.8
A combined Study from Italy, Spain and Brazil showed higher sweet food consumption in adolescents likely due to stress produced by COVID 19 confinement.9 The European society for clinical nutrition and metabolism has recently discussed about the obesity and severity of COVID 19. Adequate dietary intake might protect against inflammatory response of covid infection and might improve the disease outcomes.10 A poly phenol containing product like nuts and dried fruits such as raisins promotes the production of anti-oxidants and anti-inflammatory molecules. Polyphemus specifically flavonoids and its metabolites produce anti-oxidants and anti thrombotic effects which plays critical role in COVID 19 illness.11 A recent study on influence on immunity in COVID19 by sebastia et al. showed that sub optimal consumption of vitamin D, vitamin C, Vitamin B12 and iron is correlated with either COVID 19 incidence or a mortality indicator.12
Therefore, it is important to encourage people for healthy dietary habits and appropriate nutritional behaviour during COVID 19. This article provides insight to the general public to include dietary supplements in their diet for improving and strengthening of immune system. It is recommended that a diet with a variety of fresh foods & unprocessed food is followed daily to provide the body with the necessary vitamins, minerals, dietary fibers, protein & antioxidants.13, 14, 15
Protein
Protein makes up the building blocks of organs, muscles, skin & hormones. It’s Important to consume at least 2-3 servings of protein rich food per day. -30 gm of pulses (dal, channa, soy bean, soya chunks & Rajmah) Gives 6.3 gm protein.
Vitamin c
Vitamin C Contribute to immune defense by supporting various cellular functions of both the innate & adaptive immune system.
Vitamin d
A human body produces vit D as a response to sun exposure. A person can also boost their vit D intake through certain food items.
Egg Yolk gives 37 IU
Mushroom (30gm) gives 690 IU
Fortified Cereal (78gm) gives 36 IU
Fatty Fish (100gm) gives 526 IU
Fortified Cow Milk (237ml) gives 125 IU
Fortified Orange Juice (27ml) gives 100 IU
To keep this in mind, we have created a modified balanced diet chart for an average adult weighing approximately 60kg with appropriate nutritional requirements and immune efficacy. The appropriate requirements and above-mentioned nutritive valves have been taken from IFCT (Indian Food Composition Tables), National Institute of nutrition.16
Diet plan for an adult with 60 kg body weight
Table 1
Nutritional requirements /day
|
Calories |
2671 kcal |
|
Carbs |
267 gm |
|
Protein |
90 gm |
|
Fat |
30 gm |
|
Fiber |
35 gm |
|
Water |
2.5 -3 ltr |
|
Zinc |
17 mg |
|
Iron |
19 mg |
|
Vit. C |
80 mg |
|
Vit. D |
600 IU |
Table 2
NOTE: Add mint leave, curry leave, Coriander leaves & Condiments & spices in your all meals. It will fulfill your other minerals requirement as well like magnesium, sodium, folic acid, calcium etc.
Conclusion
The dietary recommendations and early nutritional intervention in SARS-CoV-2 exposed or high-risk subject might optimize the immune system. Such an approach is simple, cheap, and harmless to follow with adequate physical exercise. It is advisable to follow recommended upper tolerable intake levels for long-term intakes of the micro nutrients. To obtain general immunity, strict adherence to appropriate and balanced diet is very important during these COVID times. We are not sure when the self-refinement will get over but adequate nutrition might help in prevent of undue obesity caused by faulty dietary habits and sedentary life style during these times.