COVID19 or coronavirus is a worrying development and until there is a vaccine, we are all forced to fall back on our own natural resistance to fight it. This blog tells you how good nutrition for fever and resilience can help fight coronavirus COVID19.
What nutrition helps with the immune response?
Some people seem able to throw off the virus with only mild symptoms, others really suffer. Age has been noted as a factor, but the NHS advice is now making it clear that people of the same age may have very different resistance. Don’t despair just because you are over 50, or 60, or 70. In China where there is a much higher level of smoking than in UK or Europe [d], 85% of over 80s and 92% of those in their 70s who caught the virus, have survived. Considering the fact that only severe cases would have been tested, we might take a positive approach and assume that those survival figures are conservative . While compiling my update on 28th March 2020, I was pleased to see it reported in the UK, that a man of 101 years of age who tested positive has survived the disease. That’s good news.
How good nutrition for resilience can help fight coronavirus
Resilience to catching a virus such as coronavirus/COVID19 is a bit different to the resilience needed to fight the virus once it is inside your body. Tip top health is all about eating a healthy balanced diet. Good nutrition can build resilience. It might be time to review what you eat in order to ensure a well-balanced diet. But don’t worry if you are forced to eat from the store cupboard for a week or two. Frozen, tinned, dried or canned fruit and vegetables, as well as things like tinned fish or legumes are also very good for you. My balanced eating plan, available free on this website will help you learn what a healthy diet is. saytomato.org The Good Life; Healthy Balanced Diet
How does eating help? 7 tips
1. Increase the variety of food you eat
Resilience is about the whole body working well. There is no single wonder food. It is really important to eat a balanced diet, excluding ultra-processed and refined foods, but including all the five main food groups, lean protein, wholegrain cereals, fresh fruit, vegetables and dairy. In these times of food shortages don’t fret if you can only get hold of white bread. You’ll be getting the protein and many of the vitamins and minerals that are added by law to white flour. What you won’t get is the fibre – so try to boost with porridge, brown rice and loads of vegetables.
2. Don’t frivolously cut out important food groups and types of food
There is no sense in crippling your chances by excluding a food that is important to health. My own diet advice written last November says,
We should all strive to increase variety in our diet, never restrict it. Humans have prospered precisely because we were able to find nutrition from many sources of different foods, in different seasons and from different food groups. Many people have cut out really healthy foods like wholemeal bread or full milk because they think they are bad for us. In the main, they are simply providing unscrupulous manufacturers with extra profits. Don’t self-diagnose – you might be ruining your long-term health. If you’ve given up something (without medical advice) and want to try it again, simply take a little bit first time around and ramp up each time you eat it again.
3. Eat more lean protein
Resilience to infection comes from being strong and muscle strength is the simple test of strength. Remember your heart and your lungs are muscles too. They are replenished by protein and the higher quality that protein is, the better. Think lean protein, such as chicken and fish, milk, eggs and tofu. The UK government does not advise older people to eat more protein, because the government has not been persuaded by recent research. However, many countries have been convinced and have changed their advice. Countries such as Norway, Netherlands and Australia are advising older people to eat more protein. The suggestion is that protein should constitute about 15% of our diet after the age of 70. Advice is given for pure protein, not the full weight of the dish. You’ll find the content of pure protein on packaging. Australia and Zealand recommend 57g/day (0.94g/kg) body weight for women and for men over 70, 81g/day (1.07 g/kg) [a] To give you an idea a portion (85g) of white fish will contains about 16g protein. A three egg omlett contains about 18g pure high quality protein.
At a conference held in New York in 2004, Geriatrician, Professor Ronnie Chernov, University of Arkansas for Medical Sciences, pointed out that it would be wrong to assume that because our muscle mass decreases with age, that protein requirements should also decline. His view was that our need for protein increases, especially when demands increase to heal wounds, fight infection, repair fractures, or restore muscle mass lost from immobility. He said that that protein is frequently overlooked as a target nutrient in the very old patient.
However, do not be confused between a high protein diet, a high meat diet or a low carb diet. Fatty or red meat is not advisable in larger quantities. Neither should you reduce your consumption of the other four food groups. It is the added sugars, processed foods and high fat products that we should be jettisoning.
It is also important to understand that protein does not work on its own. Other essential requirements of muscle growth are hormones, glucose and vitamin D, not to mention exercise. That is why the government wishes to encourage us all to take exercise once a day. Muscle loss is created by under-nutrition in any of the five food groups and lack of exercise.
4. Boost Vitamin C
Vitamin C is an anti-oxidant, it ensures that metabolism continues to work without souring the system with free radicals. Free radicals are ‘over-sexed’ atoms of oxygen that possess an uneven number of electrons. It makes then highly reactive. Free radicals are like having a bio-electrical spanner in the works. Free radicals are able to multiply by triggering chain reactions inside cells. That diverts the cell from its proper function.
When we are fighting a virus, the first thing that happens is that our metabolism increases, as the body gets to work to make energy to fight the virus. That means we breathe more deeply and oxidation (the use of oxygen to make energy) increases. Unfortunately, this process comes with the danger that too many oxygen free radicals will emerge. As we age our systems become less well tuned to get rid of them.
That’s where Vitamin C comes in. It is able to mop up the free radicals, combining with them to neutralise all those pesky extra electrons and thus allow the job of fighting infections to continue unhindered.
In older people, reductions in vitamin C intake are associated with illness, hospitalisation, and institutionalisation. Lowered intake often is associated with lung diseases.
Good sources of vitamin C include fruit and vegetables, including citrus fruits, parsley and cabbages. I would normally recommend steering clear of shop bought fruit juices, but they can deliver an extra boost of vitamin C quickly and palatably – though a whole orange would be better. (See my comments about glucose below).
5. Vitamin D
Vitamin D is an essential nutrient in immune function. At this time of year, when the sun isn’t strong enough for us to make vitamin D by skin exposure, most older people are recommended to take a supplement of 10ug/day, new advice suggests that up to 25ug/day, might be better. Check with your pharmacists for the best dose for you and your family.
Zinc is another critically important mineral involved in our immune system. It is a deficiency that is often first observed in dermatitis and other skin conditions. We naturally get zinc from meat and dairy, but grass-fed animal foods provide a more reliable source than grain fed. This might be a good time to change your butcher and your dairy supplier, especially if you are having to shop online. There are some excellent farm producers these days.
7. Boost all vitamins and minerals
Alongside the vitamins and minerals listed above, vitamin B-12, vitamin A, calcium, iron, and other trace minerals, such as copper and selenium have all be found to be lacking in older people, who cannot metabolise them so effectively. They are all important and emphasise the importance of eating a balanced diet. Our diet should become more perfect as we age, not less so. Low nutrient, rich foods such as shop-bought cakes and biscuits, processed meats and ultra-processed packeted foods contain loads of additives, and are far less nutritious. They should be avoided, if at all possible. If you find yourself at home, then its time to get out the cookbook and experiment with some home cooked food – its likely to be better for you and provide a bit of the comfort we are all craving .
What happens if I get an infection?
When a virus, such as coronavirus/COVID19, enters the body all our reserves are brought to play in order to neutralise the virus, before it takes hold. We get a fever, which is the outward sign that the system is fighting the virus. We often think of it like a war, but I prefer to think of the immune system as an army of gardeners. Resilience is like having your bodily gardeners ready, in the potting shed, stoked with tea and toast. Once the virus hits, these gardeners will be employed ‘weeding’.
The first line of defence is our white blood cells. Our blood stream is the garden path. It is why having a strong heart is fundamental to resilience. These cells are constantly on the look-out for pathogens such as viruses, harmful bacteria and parasites. They will engulf any they find as well as sending messages back to the potting shed to engage other, more specialist ‘gardeners’.
The specialists come in a variety of shapes and sizes. The phagocytes, such as macrophages are the weeding crew. They will come in and engulf cells that have been irrevocably invaded by the virus. They have to kill the cell, or at least neutralise it, in order to kill the virus. But other phagocytes will help build new cells and strengthen the walls of our lungs and digestive tract so that viruses can’t break through them so easily.
Other ‘gardeners’, the lymphocytes, are involved in compiling a sort of gardening dictionary. They imprint into their cellular features a memory of the way a virus can be grabbed and cleared. All viruses have different signatures and that is why the coronavirus is so concerning. It is new to our species, so we don’t have any immunity to it. But these girls are quick to learn. That is why we think that once you have had coronavirus 19, you are unlikely to be re-infected straight away. Only time will tell whether this immunity will endure in the long term.
What nutrition helps with the immune response?
When a virulent strain of a new virus infects us, the efforts of the immune response gardening team must be upgraded really quickly. So, being basically healthy to start off with (at whatever age) is useful. But if you get a fever, a symptom that the weeding process has begun, you’re going to need a lot of energy quickly. If you are in hospital, they will likely put up a glucose drip, which delivers some of the energy you need – fast. In a home-based situation that’s a bit like drinking a glass of orange juice. But in intensive care, when the patient can’t eat, or can’t eat enough, then full spectrum nutrition is supplied at a far higher protein level that we normally take.
The immune system requires a lot of energy, but it is often unable to efficiently metabolise the neat glucose energy from a glucose drip. In that situation lipids (fats, often fish oils) as well as proteins are added which can be broken down and made into glucose by the body. But that itself in an energy intensive process.
In addition, if there isn’t enough protein in the diet, the body will scavenge nutrition from our muscles, which work as a reservoir of protein. The gardening team, the white blood cells, phagocytes and lymphocytes are all made of complex proteins and lipo-proteins. These proteins should only be coming from your diet. Great care is taken in an intensive unit to make sure that the patient is receiving a very balanced, but high protein diet, with a complex package of glucose, fats, proteins, vitamins, minerals and salts .
It is weird to think that someone lying in bed with a fever needs more protein than someone out in the fresh air playing hockey – but that’s the fact of the matter. Fevers use up a lot of protein. In a hospital setting that may be 50% more protein than one would have in daily life.
If you are fighting a virus at home, try to make sure that you also are eating well and widely. You may not feel hungry and in those situations, light proteins such as milk, fish and soup will help. Salads and fresh fruit, as well as fruit juice can really boost your vitamin levels – and you’re going to need every one of the nutrients to fight this. We tend to bring chicken soup and fresh fruit to the sick, and they are both really useful for people who are suffering a fever.
In the old days, before antibiotics and vaccines we used to send people to sanitoriums. There they were given the treatment of fresh air and sunshine. What wasn’t known at the time, but is known now is that the sunshine boosted their vitamin D levels, which in turn improved their ability to fight diseases, while the increased oxygen levels in the open air improved lung function.
Where do I find vitamins and minerals
Trace element deficiencies that are common include, thiamine (B1), all the B vitamins, vitamin C, copper, selenium and zinc. You can find all of these in the five important food groups, lean protein, wholemeal cereals, dairy, fruit and vegetables.
Vitamin E is found in nuts, seeds, wheat germ butter and vegetable oils. It is also a powerful antioxidant and helps maintain a healthy skin and epithelial tissue. Epithelial cells are found throughout the human body, in blood vessels and making up the skin-like inner surface of the digestive tract and the lungs. They perform important functions, including protection, fluid balance, clearance of particulate pollution, initiation of immune responses, mucus and surfactant production, and repair following injury . So perhaps remember to sprinkle a few seeds on your lunch-time salad. Nuts and seeds are also very high in protein.
There’s an old saying; feed a cold and starve a fever. This really is not true. A good balanced diet will feed your immune system ‘gardeners’ far more effectively, giving you resilience before you get the virus and helping your body to fight it if it arrives.
Updated 28th March 2020
1. Wu, Z. & McGoogan, J. M. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA (2020). doi:10.1001/jama.2020.2648
2. Chernoff, R. Micronutrient requirements in older women 1-3. (2005).
3. Singer, P. et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin. Nutr. 38, 48–79 (2019).
4. Waters, C. M., Roan, E. & Navajas, D. Mechanobiology in lung epithelial cells: Measurements, perturbations, and responses. Compr. Physiol. 2, 1–29 (2012).
b Nutrition is not the only way you can fight viruses. Fresh air and exercise are important, as is the company and support of your friends.
c If you know someone who is alone at the moment. Give them a call, see if they need anything.
d If you are a smoker, now is the time to give up. The improvement in lung function starts in a matter of days. In addition, smoking reduces muscle building and increases oxidative stress. So you’re giving yourself a triple whammy, by continuing. Giving up could make all the difference to your long- term recover.
e There is no known cure for Coronavirus/CV19 and no vaccine. Nothing in this article should be read as providing a cure. Please refer to the changing public health guidelines in your country for up to date advice.