Diet and Nutrition (Post-COVID Service)

Avoid high glycaemic index (G.I) foods: The glycaemic index describes how quickly foods make your blood sugar level rise.

• Foods that have a low glycaemic index have a slower increase in blood sugar levels which help to keep energy levels stable. These include - green vegetables, UCLH Post-Covid Service Diet and Nutrition beans and pulses, wholegrains – including wholegrain bread, brown rice, branbased cereals and oats.
• High GI foods are quickly broken down and cause a quick and sharp increase in blood sugar levels, and a crash afterwards. These include sugary drinks, sugary foods, fruit juice and smoothies, dried fruit, white bread, white pasta, white rice.
• Try to keep to regular mealtimes and avoid sugary snacks. Try to avoid eating in the 1-2 hours before going to bed as this can increase risk of acid reflux and affect sleep quality.
• Keep alcohol intake to a minimum as this can worsen fatigue for some people and impacts on sleep quality.
• Keep caffeine intake low (avoid after 12.00h) as this can worsen sleep quality and increase heart rate/ palpitations in some people.

The Mediterranean diet has been proven to have significant health benefits. Whilst this has not been tested in Long Covid, the Mediterranean diet is known to be an anti-inflammatory diet and can reduce the risk of cardiovascular disease. It is also a balanced diet and helps support immune function.

The main components of the diet include eating plenty of colourful fruit and vegetables, whole grains, beans, pulses, nuts and seeds. It also recommends unsaturated fats and lean meats such as fish, poultry, eggs, olive oil or rapeseed oil. Sugary foods, processed foods and red meat should be avoided. Plenty of water (such as 8 cups a day) is advised for hydration.

Long Covid can affect appetite and weight in different ways.

Unintentional weight gain –

• Some people find themselves eating more due to boredom, low mood, reduced energy levels and trying to boost this by comfort eating
• Reduced energy levels that affect food preparation skills mean that all of these factors may result in reaching for convenient snacks, fizzy drinks, ready meals and highly processed foods, all of which tend to have a higher fat and sugar content and fewer nutrients.
• Some people may be less physically active but still eat the same which can result in gain weight
• To help reduce weight gain, keep high fat food, sugary foods and drinks to a minimum. Try to avoid Keep these foods out of the house and make sure there are more healthy ones within reach. Avoid takeaways.

Unintentional weight loss -

• Some patients have poor appetite or are too fatigued to eat normally or have gut issues which can result in weight loss.
• If untreated, it can lead to malnutrition so speak to a healthcare professional if you are struggling to regain your weight.
• To minimise weight loss, aim to eat regularly at set times.
• Eat little and often and have nourishing snacks and drinks between meals.
• Batch cook and freeze small portions when you have energy.
• Always discuss weight loss with your G.P or clinic team so other causes can be considered.

Some people can experience gut issues such as bloating or erratic bowel habit in Long COVID and recommendations are based on advice used in Irritable Bowel Syndrome:

• Reduce caffeine and alcohol intake.
• Reduce processed and fatty foods.
• Increase fluid but avoid fizzy drinks or fruit juice.
• Chew your food well. Sit-up straight during and immediately after, slow down and practise mindful eating.
• Try relaxation exercises (see relaxation leaflet). Not all gut symptoms have a dietary trigger. Be aware of the stress response as some gut symptoms can be exacerbated by stress and anxiety.

There is some emerging evidence that a probiotic can help gut symptoms. If you are going to try one try for a minimum of 4 weeks and if you don’t see any changes or improvement, then stop. These products can be expensive and may not have long term effects if not backed up by a healthy diet that can nurture the bacteria in your gut.

For more information: https://www.bda.uk.com/resource/probiotics.html

Supplements cannot replace a balanced diet. There is no evidence that supplements can help Long Covid. However, most adults in the UK don’t have sufficient vitamin D levels in the winter months. It is recommended at 10ug (400iu) per day during October- March. Some adults have an inadequate intake of omega 3 and this could be addressed by ensuring you have a portion of oily fish portion at least once a week (or ground linseeds and walnuts as a vegetarian option). Nutritional sources are preferred to over-the-counter supplements.

High doses of micro-nutrients (vitamin C, magnesium and calcium) can cause stomach upset. Avoid exceeding the recommended daily allowance. Always let the clinic team or your GP know which supplements you are using as they can interact with other medicines.

For those struggling with recovery of their taste or smell. Please see separate leaflet on loss of smell/taste. 

• https://tinyurl.com/bdalongcovid
• https://www.plymouth.ac.uk/research/dietetics-and-health/covid-knowledge-hub