Plagued by lingering Covid-19 symptoms? Local nutrition specialist explains key to relieving those ailments and boosting immunity

We may be three years into the Covid-19 pandemic, but that doesn't mean the effects of the infectious disease have been left in the dust.

In reality, it's common to face frustrating symptoms such as chest pain, fatigue, shortness of breath and hair loss long after testing negative.

Defined as having at least one persistent symptom four weeks after being cleared of Covid-19, long Covid-19 symptoms or post-acute Covid-19 syndrome (PACS) has had a far-reaching impact on many among us.

Case in point, Asia's largest population-based long Covid-19 survey reported that 68.5 per cent of Covid-19 patients experienced at least one long Covid-19 symptom, with 30.7 per cent saying it has affected their daily work.

If you're someone who has unfortunately been plagued by these persistent symptoms, we've some good news on how you can boost your immunity and keep these symptoms at bay.

Citing scientific studies, nutrition specialist and trainer Alvin Ho shares that 70 per cent of immune cells are present in our gut and issues with immunity may have more to do with our gut health than we think.

Speaking to AsiaOne, Alvin dives deeper into the correlation between gut health and immunity, and dishes out practical tips on boosting immunity against long Covid-19.

Red flags for poor gut health

"The gut microbiome is an ecosystem of thousands of species of bacteria, viruses, fungi and other microscopic organisms living in our gut," says the 40-year-old.

"When the good and bad bacteria are thriving in a position of neutrality, this signals a healthy digestive system."

However, gut dysbiosis, or an imbalance of the gut, can occur when there is an excess of unhealthy microbes in our gut, resulting in health implications to the body, says Alvin.

In today's fast-paced society, he shares that high levels of stress and anxiety are common causes of gut dysbiosis, along with high alcohol intake, imbalanced diets and consumption of antibiotics.

Some indicative signs of poor gut health can include digestive issues such as bloating, constipation and diarrhoea, fatigue, moodiness, as well as skin problems.

Interplay between our gut flora and immunity

With about 70 per cent of immune cells residing in our gut, it's no wonder that what happens in the gut can impact our immunity.

Known as the microbiota-immune axis, this refers to the bidirectional communication between the gut microbiota and the immune system. The diverse array of microorganisms in our gut interacts with immune cells, helping to shape and regulate immune responses throughout the body.

"Good bacteria in our gut help produce metabolites that increase the production of antibodies in our blood, thereby strengthening our immune system," says Alvin.

"When there is an overgrowth of bad bacteria, they will compete for nutrients with beneficial bacteria. This may end up inhibiting the growth of beneficial bacteria and their health benefits."

Our diet and lifestyle affect the diversity and composition of bacteria in our gut, which will in turn affect our immune cells.

Battling Covid-19 by rejuvenating the gut microbiome?

Right off the bat, Alvin is quick to say that there's no conclusive relationship between gut health and the risk of contracting diseases like Covid-19 yet.

However, with studies showing how gut dysbiosis in individuals lowers their immune function, the nutrition specialist believes that the recovery process for such infectious diseases is closely linked with gut health.

In fact, one study conducted by the Faculty of Medicine from the Chinese University of Hong Kong suggests that the rejuvenation of gut microbiota using a synbiotic formula can help to boost immunity and reduce the impact of Covid-19 symptoms.

Known as SIM01, this synbiotic formula is specially developed for Asians based on metagenomic sequencing technology and big data analysis of thousands of gut microbiome profiles of Asians.

The study, which involved a group of Asian subjects infected with Covid-19, found that patients who received the formula achieved a 100 per cent symptom resolution within two weeks. This surpasses the 52 per cent symptom resolution of the placebo group.

The study also found a higher level of antibody and lower inflammation cytokine level in the group that received the SIM01. High levels of pro-inflammatory cytokines can lead to immune system dysregulation, thereby increasing susceptibility to infections and decreasing the ability for an effective immune response.

When it comes to PACS, studies found that those who suffered from long Covid-19 symptoms tend to suffer from gut dysbiosis and lacked a spread of good bacteria in their gut.

Similarly, a triple-blind study was conducted by the Chinese University of Hong Kong to evaluate the effectiveness of SIM01 in alleviating long Covid-19 symptoms. The study showed encouraging results, with those who took the formula experiencing improvement across the board. Symptoms which saw improvement include digestive problems, fatigue, difficulty in concentration, memory loss and general unwellness.

While gut dysbiosis hasn't been shown to have a direct relationship with the symptom severity of Covid-19 and recovery from long Covid-19, clinical evidence seems to suggest that improving gut microbiome can help boost immunity and recovery.

A healthier lifestyle to boost immunity

Incorporating certain lifestyle changes can be instrumental in boosting immunity and fighting infectious diseases like Covid-19.

To start with, Alvin recommends having a more balanced diet and staying hydrated. Other habits to keep up include having at least 150 to 300 minutes of moderate-intensity physical activity each week and minimally seven hours of quality sleep per night for adults, practising good personal hygiene and staying up to date with your vaccinations.

Given the links between gut dysbiosis and PACS, the nutritionist thinks it's also a good idea to manage your gut health.

And when it comes to gut health, one of the hottest topics is consuming probiotics and prebiotics – the former refers to good bacteria while the latter acts as food for probiotics.

For probiotics, think fermented foods such as yoghurt, tempeh, miso, kimchi, kombucha and cheese. On the other hand, foods that are high in prebiotics are typically rich in soluble fibre, which includes bananas, barley, garlic, onion, flaxseeds and wheat bran.

Due to stomach acid, Alvin cautions that probiotics from food sources may find it difficult to pass through the stomach and reach the intestines to perform their function.

This is where probiotic and prebiotic supplements will come into play, he says. Supplements with encapsulation technology can shield beneficial bacteria from the acidic digestive juices and allow them to reach the intestines intact.

Finding the right probiotics and prebiotics for you

Considering how probiotics and prebiotics work hand in hand to keep the gut microbiome healthy, the first step is to look for supplements that comprise a good blend of both, according to Alvin. This ensures you get both the soluble fibre and good bacteria strains needed.

Oftentimes, the number of colony-forming units, or CFU, is used to evaluate such supplements. While CFU can be used as an indicator to some extent, Alvin emphasises that it isn't a standalone factor and other aspects will determine the supplement's overall quality.

For instance, whether the supplements contain live or dead bacteria. While both live and dead cultures offer similar benefits, live bacteria have a longer lasting impact due to their ability to replicate and colonise in the gut, as opposed to dead cultures that can no longer multiply.

Finally, the choice of probiotic strains and how closely the formula fits your gut microbiome is another important consideration, says Alvin.

Each person's gut microbiome composition is unique like a fingerprint, and varies across populations depending on diet, lifestyle and living conditions. Naturally, different populations will benefit differently from specific combinations of probiotic strains, he adds.

This means that a formula which works on the gut flora of Westerners may not work for Asians, while a clinically-proven formula for Asians would more likely be beneficial for the gut microbiota of Asians.

A final piece of advice from Alvin? When selecting supplements, choose those with scientific evidence supporting their effectiveness for your specific ethnicity population so as to have the best possible impact on your body.

This article is brought to you in partnership with GenieBiome Limited (G-NiiB Immunity+).

yukiling@asiaone.com

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