• Article highlight
  • Article tables
  • Article images

Article History

Received : 18-05-2021

Accepted : 04-06-2021

Available online : 28-06-2021



Article Metrics




Downlaod Files

   


Article Access statistics

Viewed: 286

PDF Downloaded: 168

Shivnani, Shivnani, and Amle: An Optimized Dietary Plan for Strengthening the Immune System During COVID 19 Crises


Introduction

As we all know the severe acute respiratory syndrome corona virus 2 (SARS-CoV 2) had been declared a global pandemic by World health Organization in year 2020.1, 2 The usual presentation might have cough, fever, myalgia and breathing difficulties. More severe cases might present with various multi system dysfunction, septic shock or cardiac complications. These complications were believed to be associated with cytokine storm, excess immune response and hyper inflammation.3

The government has implemented various policy and restrictions on physical movements to prevent further spread of the disease. This self-confinement has created stress, sedentary life style as well as affected the dietary habits in various ways such as changes in eating behavior, limited access to food, running out of staple items, perception of food safety, higher consumption of processed and package food with high caloric content, high saturated fats, sugars and refined carbohydrate levels. All these factors with sedentary life style might increase in obesity prevalence in community.2, 3, 4 So, the purpose of this article is to provide importance of nutrient supplements and prepare a sample diet chart which can prevent the obesity at certain extent with immune booster efficacy.

Discussion

According to an observational study, the nutritional status plays a pivotal role in the clinical outcomes of patients recovering from COVID-19, and that nutritional support along with rehabilitation may improve the chances of recovery in patients of COVID-19.5

The food habits and dietary behaviour have changed due to COVID 19 pandemic. An international online survey with 1047 participants from different continents has concluded increase in sitting time and reduction and physical activity during lockdown periods. It also proved that lockdown and isolation was associated with unhealthy dietary patterns with increase snacking between meals.6 Another study from France concluded that lockdown was related to decrease in the nutritional quality of food.7 The study from Poland has concluded significant dietary modification due to quarantine with increase snacking and weight changes.8

A combined Study from Italy, Spain and Brazil showed higher sweet food consumption in adolescents likely due to stress produced by COVID 19 confinement.9 The European society for clinical nutrition and metabolism has recently discussed about the obesity and severity of COVID 19. Adequate dietary intake might protect against inflammatory response of covid infection and might improve the disease outcomes.10 A poly phenol containing product like nuts and dried fruits such as raisins promotes the production of anti-oxidants and anti-inflammatory molecules. Polyphemus specifically flavonoids and its metabolites produce anti-oxidants and anti thrombotic effects which plays critical role in COVID 19 illness.11 A recent study on influence on immunity in COVID19 by sebastia et al. showed that sub optimal consumption of vitamin D, vitamin C, Vitamin B12 and iron is correlated with either COVID 19 incidence or a mortality indicator.12

Therefore, it is important to encourage people for healthy dietary habits and appropriate nutritional behaviour during COVID 19. This article provides insight to the general public to include dietary supplements in their diet for improving and strengthening of immune system. It is recommended that a diet with a variety of fresh foods & unprocessed food is followed daily to provide the body with the necessary vitamins, minerals, dietary fibers, protein & antioxidants.13, 14, 15

Some nutrients with the strongest evidence for immune support are:

  1. Protein

  2. Vitamin C,

  3. Vitamin D, & Micronutrients

  4. Zinc

Protein

Protein makes up the building blocks of organs, muscles, skin & hormones. It’s Important to consume at least 2-3 servings of protein rich food per day. -30 gm of pulses (dal, channa, soy bean, soya chunks & Rajmah) Gives 6.3 gm protein.

  1. 1 cup (150 ml) cow’s milk gives 4.9 gm protein.

  2. 1 Egg (100 gm) gives 13.4 gm

  3. 1 cup (100 gm) Paneer gives 18.8 gm

  4. 1 Fish (100gm) gives 20gm

Vitamin c

Vitamin C Contribute to immune defense by supporting various cellular functions of both the innate & adaptive immune system.

  1. Amla 100gm gives-252 mg

  2. Guava (100gm) gives 214mg

  3. Capsicum (100gm) gives 122mg

  4. Raw Mango(100gm) gives 90mg

  5. Amaranth (100gm) gives 86mg

Zinc

Zinc is crucial for normal development & function of immune cell.

  1. Cereals (30gm) gives 0.5mg

  2. Pulses (30gm) gives 1mg

  3. Soybean (30) gives 1.2mg

  4. Nuts & seeds (15gm)gives 0.6mg

  5. 1 Egg gives 1.8mg

Vitamin d

A human body produces vit D as a response to sun exposure. A person can also boost their vit D intake through certain food items.

  1. Egg Yolk gives 37 IU

  2. Mushroom (30gm) gives 690 IU

  3. Fortified Cereal (78gm) gives 36 IU

  4. Fatty Fish (100gm) gives 526 IU

  5. Fortified Cow Milk (237ml) gives 125 IU

  6. Fortified Orange Juice (27ml) gives 100 IU

To keep this in mind, we have created a modified balanced diet chart for an average adult weighing approximately 60kg with appropriate nutritional requirements and immune efficacy. The appropriate requirements and above-mentioned nutritive valves have been taken from IFCT (Indian Food Composition Tables), National Institute of nutrition.16

Diet plan for an adult with 60 kg body weight

Table 1

Nutritional requirements /day

Calories

2671 kcal

Carbs

267 gm

Protein

90 gm

Fat

30 gm

Fiber

35 gm

Water

2.5 -3 ltr

Zinc

17 mg

Iron

19 mg

Vit. C

80 mg

Vit. D

600 IU

Table 2

Meal

Menu

Portion

Early morning

Luke warm lemon water +

1 glass

(7:00am)

Flaxseed/ sesame seed / sunflower seed

1 table spoon(15 gm)

After 20 min

Masala tea/ Turmeric milk + almond/cashew/ pistachio/walnut

70 ml/ 150ml 10 no.

Breakfast

Veg poha/ Oats + 1 orange

1 cup (100gm)

(9:00 am)

3-4 Idli + Samber+ papaya

1 Bowl+ 50 gm

2 Boiled eggs with 2brown bread + apple

Veg dal Daliya (Onion, tomato, cabbage, capsicum, peas, garlic)

1 bowl (150-200gm)

Mid-Morning (11-12 pm)

Banana/ avocado shake Fruit Salad` (guava, musk melon, watermelon, grapes, cherries)

1 glass (200ml) 150gm

Green smoothies (Palak, mint, coriander, lemon)

200 ml

Lunch

Kachumber (tomato,cucumber,cabbage,onion)

60gm

2-3pm

Any Dal (dal/ Rajmah/ chole/soya bean)

30gm

Leafy veg

30 gm

Other veg (bitter gourd/ mushroom/ Lotus stem/ drumstick)

Rice (brown/white)

30 gm

Multigrain roti (If you don’t take rice then take 3 roti)

Curd/ buttermilk

30 gm

30 gm

2 no(medium)

50gm/ 250ml

Evening

Masala tea/ muskmelon juice +

1 cup/ 200ml

5-6pm

Sprouts/ roasted peanut/channa (Add ½ lemon on it)

50gm

Dinner

Veg /Dal soup/ Chicken broth

1 bowl (150 ml)

8pm

Mix veg + roti + curd

30gm + 2 no, 30 gm

Roasted fish/ chicken

100gm

Veg dal khichdi + curd

1bowl(150gm)+ 50gm

Paneer Veg + rice/ roti + curd

50gm,30gm/12roti+30gm

Bed time

Turmeric / cardamom milk+

150ml

10pm

Walnut/ Pistachio

5-10no.

NOTE: Add mint leave, curry leave, Coriander leaves & Condiments & spices in your all meals. It will fulfill your other minerals requirement as well like magnesium, sodium, folic acid, calcium etc.

Conclusion

The dietary recommendations and early nutritional intervention in SARS-CoV-2 exposed or high-risk subject might optimize the immune system. Such an approach is simple, cheap, and harmless to follow with adequate physical exercise. It is advisable to follow recommended upper tolerable intake levels for long-term intakes of the micro nutrients. To obtain general immunity, strict adherence to appropriate and balanced diet is very important during these COVID times. We are not sure when the self-refinement will get over but adequate nutrition might help in prevent of undue obesity caused by faulty dietary habits and sedentary life style during these times.

Source of Funding

None.

Conflict of Interest

None,

References

1 

K D Ribeiro L R S Garcia J F S Dametto D G F Assunção B L Maciel COVID-19 and Nutrition: The Need for Initiatives to Promote Healthy Eating and Prevent Obesity in ChildhoodChild Obes2020164235710.1089/chi.2020.0121

2 

S Galmés F Serra A Palou Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic FrameworkNutrients2020129273810.3390/nu12092738

3 

I Zabetakis R Lordan C Norton A Tsoupras COVID-19: The Inflammation Link and the Role of Nutrition in Potential MitigationNutrients2020125146610.3390/nu12051466

4 

M J Belanger M A Hill A M Angelidi M Dalamaga J R Sowers C S Mantzoros Covid-19 and Disparities in Nutrition and ObesityEngl J Med202038311e6910.1056/nejmp2021264

5 

F Yang Y Zhang A Tariq X Jiang Z Ahmed Z Zhihao Food as medicine: A possible preventive measure against coronavirus disease (COVID-19)Phytother Res 2020341231246010.1002/ptr.6770

6 

M Iddir A Brito G Dingeo S S D Campo H Samouda M R L Frano Strengthening the Immune System and Reducing Inflammation and Oxidative Stress through Diet and Nutrition: Considerations during the COVID-19 CrisisNutrients2020126156210.3390/nu12061562

7 

E J T Aguila I H Y Cua J A C Fontanilla V L M Yabut M F P Causing Gastrointestinal Manifestations of COVID‐19: Impact on Nutrition PracticesNutrition Clin Pract2020355800510.1002/ncp.10554

8 

A Sidor P Rzymski Dietary Choices and Habits during COVID-19 Lockdown: Experience from PolandNutrients2020126165710.3390/nu12061657

9 

L D Renzo P Gualtieri F Pivari L Soldati A Attinà G Cinelli Eating habits and lifestyle changes during COVID-19 lockdown: an Italian surveyJ Transl Med202018122910.1186/s12967-020-02399-5

10 

M M Ferran F G Galipienso F S Gomar H P Galeano Metabolic Impacts of Confinement during the COVID-19 Pandemic Due to Modified Diet and Physical Activity HabitsNutrients2020126154910.3390/nu12061549

11 

A M Angelidi A Kokkinos E Katechaki E Ros C S Mantzoros Mediterranean diet as a nutritional approach for COVID-19Metab202111415440710.1016/j.metabol.2020.154407.

12 

M Bae H Kim Mini-Review on the Roles of Vitamin C, Vitamin D, and Selenium in the Immune System against COVID-19Molecules20202522534610.3390/molecules25225346

13 

M Mrityunjaya V Pavithra R Neelam P Janhavi P M Halami P V Ravindra Immune-Boosting, Antioxidant and Anti-inflammatory Food Supplements Targeting Pathogenesis of COVID-19Front Immunol20201157012210.3389/fimmu.2020.570122

14 

C D Ravagnani F C Corgosinho F Sanches C Prado A Laviano J F Mota Dietary recommendations during the COVID-19 pandemicNutr rev20097943829310.1093/nutrit/nuaa067

15 

K K Adams W L Baker D M Sobieraj Myth Busters: Dietary Supplements and COVID-19Annals Pharmacother2020548820610.1177/1060028020928052

16 

S M Gavaravarapu R Hemalatha† National Institute of Nutrition: 100 years of empowering the nation through nutritionIndian J Med Res201714854778710.4103/ijmr.IJMR_2061_18



jats-html.xsl

© This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Wiki in hindi