Nutrition and hydration
Eating well is a vital part of your Long Covid recovery. Eating a balance of different foods at well-spaced regular meals (a gap of approximately 5 hours between breakfast, lunch and your evening meal is a good guide) can positively help your mood, your sleep, and your ability to relax. Eating this way can help your mind and body recover and provide the energy and nutrients needed as you work to restore and rebuild your physical and mental strength.
The Eatwell Guide shows the ideal proportion of each of the main different food groups to include in your diet and is described in more detail at the British Dietetic Association’s website: Healthy Eating | British Dietetic Association (BDA)
The key messages are: see Eatwell Guide picture below
Choose food(s) shown in the “yellow section” of the Eatwell Guide at every meal. Wholegrain or high fibre carbohydrate (starchy foods) are generally the best choice. The starch from these foods is broken down in your digestive system to produce a steady supply of glucose which is the fuel source for your mind and body. The fibre is essential for your gut microbes (“bugs”) which will play in an important part in your recovery.
Include a food from the “pink section” of the Eatwell Guide at every meal too. These are good sources of protein. Your muscles need protein to help them rebuild – many people find they have lost muscle mass during their Covid recovery. Animal products such as meat, fish, eggs and dairy foods (e.g. milk, cheese and yoghurt) are good sources of dietary protein. Protein also comes from foods of plant origin. Pulses, nuts, and seeds are all high in protein and also provide fuel for your gut microbes.
Try to have at least five portions of different fruit and vegetables each day (see the “green” section). Like carbohydrates, fruit and vegetables should account for about one third of what you eat each day. Dried, frozen, tinned, as well as fresh choices are all included. Variety is the key, as fruit and vegetables are more fuel for your gut microbes.
Make sure you have plenty of fluid each day. A general recommendation is to aim for 1.5 to 2.0 litres of fluid every day. This should preferably be water but you can include regular tea, herbal tea or coffee without sugar. Some people do comment that they need more fluid than they would expect, which may be a result of trying to combat unwanted taste changes. But drinking too much can stop you feeling hungry. Conversely not drinking enough can make you feel more tired or be prone to more headaches. The colour of your urine is a good guide to whether you are getting things right – it should be a light straw colour. If it is always darker than this, you are not drinking enough. Lighter than this and you are probably drinking too much.
Try to avoid (or reduce) sugar and sugary foods and drinks. These do give you a quick “boost” of energy that you may be craving, but they release glucose into your bloodstream very quickly and the body has to ‘do’ a lot to ensure that its natural balance isn’t upset. This requires a lot of energy and explains why people often feel drained after having a quick sugar ‘fix’.
If you feel hungry between meals, try to choose a plant-based food that is a good source of protein or use it as an opportunity to eat different vegetables. A great advocate of making this more interesting than it sounds is Registered Dietitian Dr Megan Rossi – the Gut Health Doctor – see Home - The Gut Health Doctor
Some people with Long Covid experience symptoms that hinder their ability to eat well and hence support their recovery. People describe taste and/or smell disturbances (of varying severity and duration) and gastrointestinal symptoms (including reflux, heartburn, abdominal bloating, constipation and diarrhoea) that range from being mildly annoying to very distressing. There is a comprehensive knowledge hub “Covid-19 recovery and your diet” on the website of the University of Plymouth. This should help you find strategies to help lessen the impact of your symptoms. You can find this at: https://www.plymouth.ac.uk/research/dietetics-and-health/covid-knowledge-hub/patients
Unintentional weight gain
Unintentional weight gain is a common unwanted side effect of Long Covid.
Some people find themselves eating more than normal (often due to low mood, boredom, eating for comfort, or to calm feelings of worry or anxiety) and eat ‘quick fix’ sugary foods for the hope of comfort or an energy boost.
At the same time, Long Covid means they are also a lot less physically active. The side effect of ‘eating more’ and ‘moving less’ is weight gain, which can lead to increased fatigue and all the challenges this brings.
If this is you, try to incorporate the Eating Well recommendations on a daily basis and try to find non-food solutions to help your experiences of low mood, boredom, anxiety, worry or need for comfort. Enlist the support of friends and family, try the relaxation and restoration techniques suggested in this Guide to help you to help yourself in the best and kindest way for you.
Unintentional weight loss
Unintentional weight loss is another unwanted side effect of Long Covid
Increased energy requirements (due to the burden of the disease and inflammation), and reduced energy intake (for a whole variety of reasons) mean that some people lose weight. This often includes a loss of muscle mass, which is not good, but can be remedied by what you eat and drink.
The Eating Well recommendations still apply, but you may need to adapt things in the short term to help you return to your “happy, healthy weight”. Sensible steps are to:
Try to eat “little and often” – and try to include “nourishing snacks” and/or “nourishing drinks” between your meals.
‘Fortify’ your meals with calories so that you can eat smaller meals (if you need to) that give you plenty of energy and help you slowly and steadily gain weight.
For more advice on nourishing snacks and drinks, food fortification techniques and other strategies for managing a poor appetite and preventing malnutrition, visit: Malnutrition | British Dietetic Association (BDA)