We have had an interesting couple of years with Covid- not just in terms of isolation and scanning apps- but also in regards to our health. We have seen many clients who, although recovered from Covid-19, are still struggling with symptoms months later. This is being referred to as Long Covid and the symptoms can vary alot- making it tricky to pinpoint what exactly may be causing our health issues!
This list gathered from bda.uk shows some of the commonly reported symptoms- which rest assured can absolutely get better over time.
Common reported symptoms include:
extreme tiredness (fatigue)
memory and concentration problems ("brain fog”)
feeling sick, diarrhoea, stomach aches, loss of appetite
changes to smell or taste
shortness of breath
chest pain or tightness, heart palpitations
difficulty sleeping (insomnia)
pins and needles
depression and anxiety
high temperature, cough, headaches, sore throat
(List sourced from bda.uk.com)
We have also seen interesting changes in gut health and associated symptoms, and as a result much confusion among people around whether they need to be eliminating food groups or specific foods to improve their symptoms.
It's important for me to mention here that although these symptoms can be related to "long covid"- it doesn't mean that they are not serious. If you are suffering from the above then it is important to check ongoing symptoms with your GP to rule out any other potential causes and ensure that you are not at risk.
So where does nutrition come in?
Nutrition can play a crucial role in our recovery.
With any cold/ flu like illness, our body needs a balanced and wide variety of vitamins, minerals, protein, energy, fibre and fluid in order to recover as fast as possible. Focusing on eating enough food, plenty of variety, and including anti-inflammatory foods is an important step in recovery. We do not advocate for specific diets but the Mediterranean style of eating is a great example of an anti-inflammatory eating pattern.
Some key diet points to think about in your recovery from covid, colds, flus and illness throughout these colder months:
Do not cut your calories too low! Inadequate energy intake will prolong your illness and potentially make things worse- leading to infections or pneumonia. If you are feeling unwell, make sure that you are consuming foods that you can tolerate in small amounts frequently across the day.
Include plenty of slow digesting foods to prevent crashes in blood sugars and energy. When you are already feeling low- there is nothing worse than adding a sugar/ carb crash in energy on top of this. Choose low GI/ slow digesting, grainy foods like wholemeal pasta, brown rice, grainy breads and crackers.
Each day, aim to have at least five serves of veggies and atleast 2 serves of fruit. This will give your body some important vitamins, minerals and fibre. Fresh, frozen, tinned or dried all count and the more variety the better. This is made easier with soups, smoothies, and small amounts of different fruits and veggies in bakes and stews. Remember- every food has a different nutrient profile. So the more variety- the better!
Protein is vital in recovery. Protein provides us with essential amino acids which allow us to heal in times of illness. Again- variety is great. Include some form of protein at every meal and snack: Beans, pulses, nuts and seeds, fish, chicken, eggs and meat are good sources of protein. Processed meats like sausages, burgers, bacon, and ham are high in protein but won't pack the same punch of goodness as they also contain preservatives.
Omega 3 is vital for reducing inflammation. Research shows that even if we are eating "healthy", an imbalance of omega 3 and omega 6 fatty acids can increase inflammation. Oily fish like salmon and sardines are amazing and I encourage you to include these twice a week if you can (tinned or frozen is fine). If you don't like fish- you can get your omega 3 through walnuts, pumpkin and chia seeds, linseeds, flaxseeds and flaxseed oil, soy beans, soy milk, or tofu.
Hydration! Your body needs atleast 2 L of water each day. If you don't feel thirsty- it doesn't mean that you don't need the fluid- your body has just adjusted to lower intakes of water. Include herbal teas, sparkling water, and hot lemon drinks for variety or try a diffuser drink bottle filled with herbal tea bags or fruit if you aren't a plain water fan.
What can I do if I lose my smell and taste after being sick with covid?
I think that not being able to taste food is like a form of torture. Food is far too good to not be enjoyed! Rest assured that this symptoms shouldn't last long, and if it does then absolutely get it checked out. Research carried out by the NHS shows us that adding lots of flavour, spices, and sharp flavours to food can make it easier to taste. Strong flavours like citrus can also be easier to taste and provide you with a more enjoyable eating experience when you are unwell.
What can I do to help my gut health?
Many of our clients are now suffering from bloating, nausea, pain, and bowel changes which they didn't have prior to covid. These are considered IBS symptoms and for many people will resolve as your body heals. If you have a family history of coeliac disease or feel that your symptoms have been ongoing for a while- then it would pay to be tested with your GP to rule this out.
There is plenty of evidence now which tells us that the gut microbiome plays a huge role in our health. This is partly why often after taking a course of antibiotics or suffering from a gastro bug we then fall unwell with another illness like a cold or flu. Eating for gut health includes focusing on variety, fibre, and fermented foods. Probiotics are worth considering but we recommend that you trial these for a month to test whether you tolerate them, and if they make a difference to your symptoms. Research around the relationship between long covid and probiotics is limited at this stage. It's important not to rely solely on probiotic supplementation for gut health as without a "wrap-around" approach, the probiotics will be far less effective. Prebiotics or high fibre foods are essential for the survival of good gut bugs so getting the diet right first is key. Avoiding processed foods, alcohol, and sugar has also been shown to be important in maintaining a great colony of gut bugs and of course will provide plenty of other benefits to our health and recovery from illness too.
The gut is linked closely to many parts of our health and is hugely affected by our sleep and stress levels. We take a very holistic "whole body" approach to diet and lifestyle change and we recommend that you absolutely do the same in order to see optimal results.
Should I take vitamin and mineral supplements?
There is no answer to this that is applicable to 100% of people as every single persons needs are different. However, supplementation has been a hot topic over the past couple of years and absolutely one to be discussed.
Vitamin D is one of many in the list of trending covid-related nutrients. It has a big role to play in bone and muscle health and definitely immunity. Around the world we have seen "blanket" supplementation of this nutrient however there is no evidence that this is needed in NZ. There is evidence to show that high levels of Vit D can have adverse effects so we recommend prescription only to those at risk of Vit D deficiency which can be determined through discussion with your dietitian or GP. The best way to ensure that you are getting enough Vit D is through sunlight exposure (get outside for atleast 10-15 minutes when the sun is shining!) and a balanced diet. In saying this, vitamin D supplementation can be highly beneficial to many so please discuss with your dietitian if you are interested in exploring this.
Large doses of vitamin C, B3, D, and zinc have been taken by many lately however again, not always necessary. Taking supplements can give us a false sense of confidence that we are safe from illness but without a balanced diet we just won't see the maximum benefit. We have however seen adverse effects of high intakes of these nutrients so recommend that if you want to supplement with something then you are far better to take a "one a day" multivitamin than large doses of individual vitamins or minerals. This is more likely to provide you with what you need, without the side effects of taking an excessive amount.
Omega 3 supplementation may also be beneficial in the reduction of inflammation. If you feel like you may be getting inadequate Omega 3 intake through your diet then this is definitely a supplement to explore further.
One common symptom of Long Covid and colds/ flus in general is aching muscles and/or restless legs. Magnesium supplementation may be beneficial for those suffering with this. Magnesium can cause sleepiness and changes in bowel habits so this one has the potential to benefit many, but should be explored with some monitoring around other side effects.
The evidence behind a low histamine diet and long covid
A few mentions around a low histamine diet for long covid have been made in recent months. This is thought to be because when we are sick the levels of histamine will increase in our body as part of an inflammatory response, or that we might struggle to break down histamine after a period of being unwell. At present there is no clear evidence to support this as robust studies have not yet been carried out. Despite this, we have seen many people undertaking a low histamine diet in order to combat long covid so my advice on this is that elimination diets of any kind should always be done with the guidance of a dietitian to ensure that nutritional adequacy is still achieved. A low histamine diet can be time-consuming to adhere to and without proper guidance around carrying this out, we can see inadequate intakes of other nutrients, vitamins, and minerals. The lists of "low histamine" foods and diets available on the internet are questionable with much conflicting advice. If you want to explore this further for your symptoms then I would definitely recommend that you reach out to a registered dietitian and they can guide you on establishing the best course of action for your body and nutrient requirements.
Unintentional weight loss:
Losing weight unintentionally or being unable to eat due to changes in taste, nausea, fatigue, gut upset, or other debilitating symptoms are all causes for concern and we highly recommend that you seek advice on this.
If you are struggling with eating then we recommend focusing on eating small amounts often across the day. Choose high calorie foods and drinks and make sure not to leave big gaps between meals as this can worsen nausea. Ginger, salty foods, and cold or hot foods may be easier to tolerate when unwell.
So in summary, what can we do to aid our recovery from Covid and reduce the severity of Long Covid symptoms?
Focus on whole, real foods with plenty of variety for maximum nutrient, vitamin, and mineral intake
Avoiding cutting calories too low and restrictive diets
Aim for a mediterranean- style diet with plenty of unsaturated fats, oily fish, nuts and seeds, extra virgin olive oil, fruits and veggies, and wholegrains.
Seek advice on supplementation or specific elimination diets to ensure nutritional adequacy
Most importantly- be kind to yourself! Slowing down when you are unwell is one of the best things that you can do for your recovery. Focus on small, gradual changes and stack new positive diet and lifestyle habits on top of existing ones.
If you would like more support on your specific dietary needs then please reach out to our dietitian team. We are here to support you in discovering just how food can benefit your health, and how amazing you can feel when your diet is optimized.
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