Fatigue, dyspnea and loss of appetite in post-COVID patients hampers nutritional intake
Nutrition is a vital component in the recovery of a COVID-19 patient while diet guidelines need to be customized upon assessment of physical activity, disease-related symptoms and other co-morbidities.
“Patients recovering from COVID-19 experience the clinical symptoms of fatigue, dyspnea (shortness of breath) and loss of appetite which make it difficult to eat well, leading to several nutritional deficiencies. Hence, a personalized plan for diet, nutrition and fluid intake needs to be created in consultation with an expert”, advised Ms. Ruba El Hourani, Head Dietician at RAK Hospital. She was speaking from her experience of treating post-COVID patients who showed a clear shift in diet pattern, finding it difficult to eat normally.
Dr. Raza Siddiqui, Executive Director of RAK Hospital said: “The majority of the patients who joined RAK Hospital’s first-of-its-kind ‘Covid-19 Rehabilitation Programme’ were suffering from loss of appetite while some had difficulty swallowing. In few cases, it was linked to the mental stresses and sleep disturbances as anxiety in COVID patients can cause such symptoms. Our initiative is aimed at providing physical, cognitive, dietary and psychological support to COVID patients in their recovery or post-recovery phase in a structured and holistic way”.
Ms. El Hourani further added: “We also noticed discoloration of nails and dry skin patches – which can be attributed to inappropriate fluid intake – and sudden hair loss, again due to insufficient diet”.
Eating a well-balanced diet helps regain the strength lost because of the infection as even milder cases of infection can experience poor appetite and, at times, weight loss. Therefore, it is essential to get the most from food and that is only possible if patients understand how each food behaves and what kind of nutrition it provides. Those recovering from COVID-19 need more building blocks (like proteins) to repair their bodies and more vitamins and minerals to help the process along.
COVID patients at RAK Hospital go through a complete evaluation process which addresses common residual COVID-19 symptoms, specifically breathlessness, starting exercise, getting back to functional activities, mental health and post intubation symptoms such as voice weakness, eating, drinking and attention and memory deficits. The initiative helps people to regain their physical and mental strength, while also learning how to maintain a healthy lifestyle.
Ms. Ruba suggests to follow the below guidelines to fulfill the body’s nutritional needs during the post COVID-19 recovery period:
- Include more protein-rich foods as these are the building blocks of life. Add whole grains, dairy products, nuts, seeds, lentils in the diet. Chicken, eggs and fish can also be added.
- Make sure to follow food safety and hygiene guidelines while preparing food.
- Since eating large portions may be difficult in the initial phases of recovery, eat smaller but frequent meals. Difficulty in swallowing food during the recovery period could hamper food intake, hence opt for liquids, soft or mashed foods instead.
- Make sure all meals are simple, healthy and freshly cooked at home; avoid take-away and eating out.
Eat fresh and unprocessed foods every day
- Eat fruits, vegetables, legumes (e.g. lentils, beans), nuts and whole grains (e.g. unprocessed maize, millet, oats, wheat, brown rice or starchy tubers or roots such as potato, yam, taro or cassava), and foods from animal sources (e.g. meat, fish, eggs and milk).
- Daily, eat: 2 cups of fruit (4 servings), 2.5 cups of vegetables (5 servings), 180 g of grains, and 160 g of meat and beans (red meat can be eaten 1−2 times per week, and poultry 2−3 times per week).
- For snacks, choose raw vegetables and fresh fruit rather than foods that are high in sugar, fat or salt.
- Do not overcook vegetables and fruit as this can lead to the loss of important vitamins.
- When using canned or dried vegetables and fruit, choose varieties without added salt or sugar.
Drink enough water every day
- Water is essential for life. It transports nutrients and compounds in blood, regulates the body temperature, gets rid of waste, and lubricates and cushions joints.
- Drink 8–10 cups of water every day.
- Water is the best choice, but one can also consume other drinks, fruits and vegetables that contain water, for example lemon juice (diluted in water and unsweetened), tea and coffee. But be careful not to consume too much caffeine, and avoid sweetened fruit juices, syrups, fruit juice concentrates, fizzy and still drinks as they all contain sugar.
Eat moderate amounts of fat and oil
- Consume unsaturated fats (e.g. found in fish, avocado, nuts, olive oil, soy, canola, sunflower and corn oils) rather than saturated fats (e.g. found in fatty meat, butter, palm and coconut oils, cream, cheese, ghee and lard).
- Choose white meat (e.g. poultry) and fish, which are generally low in fat, rather than red meat.
- Avoid processed meats because they are high in fat and salt.
- Where possible, opt for low-fat or reduced-fat versions of milk and dairy products.
- Avoid industrially produced trans fats. These are often found in processed food, fast food, snack food, fried food, frozen pizza, pies, cookies, margarines and spreads.
Eat less salt and sugar
- When cooking and preparing food, limit the amount of salt and high-sodium condiments (e.g. soy sauce and fish sauce).
- Limit daily salt intake to less than 5 g (approximately 1 teaspoon) and use iodized salt.
- Avoid foods (e.g. snacks) that are high in salt and sugar.
- Limit the intake of soft drinks or sodas and other drinks that are high in sugar (e.g. fruit juices, fruit juice concentrates and syrups, flavored milks and yogurt drinks).
- Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate
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