SINGAPORE, Nov 27 – It is not unusual for people to lose their appetite and eat less when they are sick. And with a changing perception of taste and smell as one of the common symptoms of Covid-19, food intake can take a further drop.
However, eating and drinking well is even more important when one falls ill.
Dietitian Ang Ming Hui of the Department of Nutrition at National University Hospital (NUH) said the body needs more energy and fluids when fighting infection.
“Prolonged insufficient energy and protein can lead to muscle loss, exacerbation of fatigue, and impede recovery.
“It is important that people continue to eat and drink even when they are not hungry or thirsty, to get enough nutrition to support their immune systems and protect against muscle loss,” Ang said.
With the majority of people diagnosed with Covid-19 having to recover at home as the default measure here, experts explain why it’s important to eat right, how to overcome poor appetite and loss of smell and taste, and the essential nutrients to support the recovery process.
Why is there a loss of appetite?
Dr. Jonathan Chung, a resident physician at the DTAP clinic, said that people with Covid-19 may experience a variety of symptoms. One of these reasons is that their sense of taste and smell may be temporarily reduced or lost.
Based on a review of 10 studies, it is estimated that 52% of Covid-19 patients reported an abnormality of smell and 44% reported taste disturbances.
Dr Chung explained: “Our perception of taste is closely related to our sense of smell. As such, when someone has a diminished or completely absent sense of smell due to Covid-19, a lack of taste may affect their appetite because food is perceived as nicer than the usual “.
Covid-19 may also directly alter taste perception. For some people, he added, the taste of food may be “metallic” or even bitter.
Moreover, when a person is ill, they may generally feel more tired and have a poor appetite as their body is fighting a viral infection.
“This is a common symptom of many viral infections, not just Covid-19.”
How to deal with weight loss, sensory changes
NUH’s Ang said patients may notice some weight loss when they are unable to meet their increased nutritional requirements during an injury.
“To prevent further weight loss, rebuild strength and maintain the immune system, they should try to eat small, frequent meals.”
For most people, symptoms of abnormalities in smell and taste are not permanent and will resolve over several weeks without the need for treatment or intervention, Dr. Chong said.
He noted that a survey of Covid-19 patients in Italy found that more than four out of five (83 percent) of them reported complete taste and smell recovery on average 37 days after symptoms first appeared.
For those experiencing changes in their sense of taste and smell, Ang suggested starting with light foods, especially if they also felt nauseous.
For example, dry food such as crackers or toast may be easier on the stomach. And in Asian countries, eating porridge may be the most popular option due to its ease of digestion.
To make dishes more appealing, consider adding herbs and spices such as pepper, five-spice powder, cinnamon, curry powder, garlic, parsley, coriander, and rosemary.
“Be experimental,” Ang added.
“One can experiment with foods of different textures, flavors and temperatures to discover new food preferences when there is a change in the palate.
“For those with dry mouth, try sucking on sour candy, popsicles, or citrus fruit slices to stimulate saliva production.”
Ang said citrus fruits are “not contraindicated during diarrhea,” which means they don’t harm a person with diarrhea.
Why staying hydrated is important
Dr Chung said Covid-19 can also cause patients to lose more fluid than usual, through the skin or respiratory tract.
Besides gastrointestinal symptoms such as nausea, vomiting and diarrhea, fluid loss may worsen and further impair recovery time if not replenished properly.
“Dehydration can lead to low blood pressure, electrolyte abnormalities and symptoms such as dizziness and lethargy,” he said.
To prevent dehydration during an infection, Ang advised drinking plenty of water or other fluids such as barley water, coconut water, soy milk, lemon-infused water, soup, and milk.
If there are gastrointestinal symptoms, milk or other products containing lactose should be avoided temporarily.
She added that an oral hydrating solution that contains a blend of minerals is also a good way to restore fluid loss, and can be easily purchased at drugstores.
Dr. Chong said that for patients who cannot adequately eat or drink while they have an infection, they may need more support such as intravenous fluids.
What to eat to support recovery
Dietitian Ang said the body needs energy, protein, vitamins and minerals to support recovery from infection. For a balanced meal, I suggested referring to the concept of “my healthy plate” where:
A quarter of the plate should be filled with foods rich in carbohydrates such as rice, bread and pasta, they are a good source of energy
Another quarter should be filled with protein like meat, fish, tofu or eggs to help prevent muscle loss and maintain the immune system
Half of the plate should be occupied by fruits and vegetables. They provide important minerals and vitamins to support the immune system and recovery from Covid-19
It doesn’t take much to quickly prepare a nutritious meal with minimal effort. Ang suggested having these beneficial ingredients at home:
Frozen fish, shrimp, vegetables, mushroom. Most are pre-washed and pre-cut, which means that minimal preparation is required before cooking. They can be added to pasta or pasta or as a side dish with rice, made into an oven-baked meal from a single tray or cooked on the stove.
Canned tuna can be used in sandwiches, eaten with a casing, or added to pasta
Store-bought low-salt broth can be cooked with staples such as kway teow, noodles, udon or noodles, followed by tofu, meat, frozen prawns, or fish to taste. Add some vegetables for a balanced meal
Peanut butter can be eaten with toast or crackers, or made into a peanut butter milkshake.
Nuts, seeds, soy pudding, yogurt, and soymilk or milk are convenient and nutritious snacks to keep at home
Chicken or ground beef porridge makes an easy meal in one bowl, but my heart is with some boiled green vegetables
A balanced one-pot soup can be made using chicken, carrots, potatoes, cabbage and celery
Do vitamin supplements help?
Ang said that some vitamins and minerals, such as vitamins C and D and zinc, are known to be important for the immune system to function normally.
For example, she noted, the immune system can be damaged in those with vitamin D or zinc deficiency, which can be confirmed with blood tests.
Vitamin D deficiency can be especially common in people who stay indoors most of the time and who are deficient in a diet rich in vitamin D. They are found in oily fish such as salmon or sardines, eggs and fortified dairy products.”
However, the jury is still out on whether taking certain vitamins is particularly beneficial when one has Covid-19.
Ang said a review published earlier this year analyzed the link between vitamin D supplementation and the prevention of acute respiratory infections.
showed that vitamin D supplementation of 400 to 1,000 international units (IU) was generally safe and was shown to have a protective – although small – effect against acute respiratory infections.
However, it remains unclear whether these findings are applicable to Covid-19 patients.
There are also ongoing studies of vitamin C supplementation in Covid-19 patients.
“Human bodies are thought to be stressed during infection, and vitamin C, as an antioxidant with anti-inflammatory properties, may be beneficial.
“However, none of the research has shown compelling evidence to support or oppose the use of vitamin C supplements during Covid-19,” Ang said.
Currently, she added, there is not enough evidence and data on the recommended amount of vitamin C for people recovering from COVID-19 or to prevent infection.
For the body’s daily needs, it is still necessary to ensure that a person gets adequate vitamin C.
She said the recommended daily amount for women is 85 mg of vitamin C, 8 mg of zinc, 105 mg of vitamin C and 11 mg of zinc for men.
Foods rich in vitamin C include citrus fruits such as oranges, guavas, strawberries, broccoli and peppers.
“Those who struggle with binge eating due to loss of appetite or fatigue can consider taking a multivitamin that meets but does not exceed the recommended dietary allowance.
Ang cautioned that “it is always wise to consult a doctor before starting any supplement as excessive doses can lead to potential side effects.”
People may also consider nutritionally complete beverage supplements to meet their calorie requirements while recovering from infection, said Simon Tan, pharmacist by training and general manager of HST Medical, a Singapore-based health and wellness company.
These are available at drugstores and supermarkets that carry certain brands of these beverage supplements.
For those considering a vitamin supplement, Tan said, it’s a good idea to follow the recommended dosages on the product packaging. – Today