What to eat and what not to eat when you are down with Covid-19

SINGAPORE - Your head is pounding, your throat is sore. You have a persistent cough and feel very fatigued. You might not be able to smell and taste your food.

Yes, you are one of tens of thousands of people in Singapore who have come down with Covid-19.

The temptation is to order in, to snack while holed up in your room, or maybe to have a stiff drink or two.

If you want to feel better and recover, hold your horses.

Dietitians say there are better food choices.

Three, from National University Polyclinics (NUP), Khoo Teck Puat Hospital (KTPH) and Changi General Hospital (CGH), advocate sticking to a balanced diet.

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Dietitian Bernice Tan from NUP says: "We would still recommend that patients have a healthy balanced diet and encourage them to have meals which consist of whole grains, lean protein, vegetables and fruit, to boost energy and facilitate speedy recovery.

"However, they may not have much appetite due to the lack of energy and existing symptoms that can affect their usual food intake. The texture of food can be modified to help them eat better, especially if they still feel unwell."

She says food can be cooked longer to make it softer and easier on the throat. Some examples include rice porridge, soupy noodles, fish, stewed meat, tofu, eggs and soft fruit such as papaya, banana and watermelon.

Some deep-fried and high-fat food, she adds, pass through the gastrointestinal tract too quickly and can cause diarrhoea. Or they may stay in the stomach longer and cause bloating.

The combination of acids in spicy food can cause a burning sensation in the throat and stomach too.

It is also advisable to avoid ultra-processed food such as chocolates, sweets, ice cream and chips as they are low in nutrients.

"Remember, the body needs nutrients to recover," she adds.

Dietitian Tan Ying Xin from CGH says it is not uncommon for people recovering from the virus to have a reduced sense of taste and smell.

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She says: "This can affect their appetite as food may be perceived to be more bland than usual. Combined with the discomfort of a sore throat and/or a cough, a patient may end up passing over his or her healthy eating habits. "

For example, some may increase the amount of sauces or salt in food to compensate for the lack of taste. Excessive sodium intake, unfortunately, may increase blood pressure and the risk of hypertension, she warns.

When people with Covid-19 are staying home to recover, she notes there may be a higher tendency to use food delivery services or consume more overly processed food, such as instant noodles, canned cream soup or long-life pastries.

"Doing so will increase the intake of salt and saturated fats," she says.

Ms Chow Pek Yee, head of KTPH's Department of Nutrition & Dietetics, adds that hydration is important to replace lost fluids, prevent dry throat and avoid triggering a cough.

She suggests adding lemon, berries or mint leaves to flavour water, if water on its own is deemed too plain or boring.

CGH's Ms Tan notes there has been a lot of hype about consuming coconut water post-vaccination and while recovering from Covid-19.

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"There is, however, no evidence that coconut water will cure one of Covid-19," she says.

"Beverages such as coconut water and isotonic drinks contain electrolytes such as potassium and sodium, and may benefit someone who is experiencing a deficit from excessive fluid loss from diarrhoea.

"But bear in mind that they still contain carbohydrates, sometimes in the form of added sugar. Avoid consuming excessive amounts. Plain water is still the best form of hydration," she advises.

The dietitians also offer practical advice for people who want to manage their diets well, while recovering from the virus.

Ms Tan from NUP says people who are struggling to eat their usual food portions can have healthy snacks two to three hours after their main meals, to make sure they are getting enough nutrients.

She suggests a slice of wholemeal bread with soft margarine, jam with no added sugar or low-fat cheese; a cup of warm low-fat milk or reduced-sugar, high-calcium soya milk; or a small tub of low-fat yogurt.

CGH's Ms Tan also suggests buying thinly sliced meat, which defrosts and cooks quickly. Citrus fruit are high in vitamin C, and can be eaten on their own or used to flavour water and salad dressing, she says.

Also consider boosting the protein content in food by cooking with milk, which can be used in place of water when cooking oats, or used to soak oats overnight in the fridge for breakfast the next day.

She adds: "Now that people are spending longer periods at home, it is good to take this as an opportunity to prepare more wholesome meals or explore recipes they previously did not have the time to make.

"Plan ahead and take advantage of food delivery platforms to deliver fresh ingredients such as vegetables, meat and poultry too."

In the long run, however, it will take more than eating healthily to boost the immune system to be Covid-19-free.

Ms Chow from KTPH says: "To ensure our immune system is healthy all year round, we need to ensure we eat well and have a balanced diet and adequate sleep, and manage stress."

She and the other dietitians advocate the Health Promotion Board's My Healthy Plate concept. The idea here is to have half a plate of vegetables, a quarter of a plate of protein-rich foods and a quarter of a plate of whole grains.

She adds: "Eat at least two servings of fruit daily and keep well hydrated. At Khoo Teck Puat Hospital, our five pillars of health are: eat wisely, exercise regularly, be happy, stop smoking and practise good hygiene."

Foods to help you heal

Ms Tan Ying Xin, a dietitian at Changi General Hospital, suggests these foods to help Covid-19 patients recover:

1. Lean animal protein such as meat, poultry and seafood.

2. Eggs, which are a source of vitamin A and protein, and versatile.

3. Citrus fruit, which are high in vitamin C.

4. Unsweetened milk fortified with vitamin D.

5. Nuts and seeds, which are sources of vitamin E.

Foods to avoid

Ms Bernice Tan, dietitian at National University Polyclinics, suggests avoiding the following:

1. Deep -fried and high- fat food such as fatty cuts of meat and butter

2. Processed meat

3. Ultra -processed foods

4. Spicy food such as mala dishes or dishes with chilli

5. Alcohol, as it irritates the stomach lining, causing indigestion and making patients feel more nauseated.

This article was first published in The Straits Times. Permission required for reproduction.