For some people, COVID-19 causes symptoms that last way beyond the initial infection. In fact, this post COVID-19 syndrome, or to use its nickname 'long COVID', can last months and possibly even years (only time will tell) after the initial infection. Although nutrition is not a cure, finding nutritional strategies to support long COVID symptoms can help to alleviate some of the long-lasting effects.
We asked Jenny, the Lunchbox Doctor, how nutrition can support those of us with long (or suspected long) COVID.
According to some estimates, there are millions of people worldwide affected by long COVID. Some of the most hard-hitting symptoms are fatigue, brain fog and muscle aches. Does this sound familiar? Whilst some assume that long COVID only affects people who experienced a severe coronavirus illness, that’s not in fact the case. Although long term illness is more common in those with the worst initial infections there are plenty of people who didn’t seem to suffer too badly at the start but who have gone on to experience debilitating and long-lasting illness. Let’s find out how nutrition could help with some of the most challenging symptoms of long COVID.
Fatigue
While sticking to a regular sleep pattern is important, supporting this with regular and consistent meals is also key. Eating three regular meals a day can help to avoid energy rollercoasters where your blood sugar level drops. This can put your already challenged body under further strain as it tries to rectify your blood glucose by adjusting the production of hormones. Choosing carbohydrate sources that have a low glycaemic index (GI) is another way of reducing the likelihood of blood sugar dips. Low GI foods are those that release energy more slowly into the body rather than sweets, biscuits, white bread and rice. Foods low in GI include beans, lentils, whole grains such as oats and brown rice, wholegrain pasta, vegetables and fruit.
In addition to planning your meals to include low GI carbohydrates, it would also be a great idea to have snack pots ready for moments when you experience energy dips. Some ideal combinations would be yoghurt mixed with berries, mozzarella balls with cherry tomatoes, dates stuffed with peanut butter or hummus and vegetable sticks.
Nutrients to pay particular attention to if you’re suffering from fatigue are vitamin C, iron, B vitamins and magnesium. These are all associated with improving energy levels. Low iron levels coexist with the worst COVID symptoms [1] and in some cases restoring iron and B12 levels has shown vast improvements in long COVID symptoms. Vitamin C helps you absorb iron so eating foods rich in iron and Vitamin C together is ideal. Try scrambled eggs with spinach and a small glass of orange juice for breakfast, a spinach and chickpea curry or a prawn stir-fry with a rainbow of vegetables for your lunch or evening meal. B vitamin and magnesium-rich foods include dark green veg, nuts, seeds, pulses, wholegrains, and fish. Try stir-fries with broccoli, cashew nuts or peanuts and wholegrain rice, or a spinach and lentil dahl, for example.
Brain fog
Estimates suggest that a quarter to two-thirds of all people experiencing long COVID suffer some form of brain fog [2]. If you’re one of that huge number of people, then you’ll know exactly what brain fog is. If you’re someone supporting a long COVID sufferer, then I am sure they’ve tried to explain it to you. One description that seems to make sense and may also make those suffering smile knowingly is this;
Brain fog is akin to swinging from tree to tree, only your rope isn’t long enough to get you to your next destination.
A January 2021 study found increased levels of inflammatory molecules (known as cytokines) in the fluid surrounding the brains of people weeks after they had suffered COVID infections [3]. Inflammation in the brain is known to hinder the ability of your nerve cells to communicate with one another. Omega-3 fats are known for their anti-inflammatory properties. One of the best sources of omega-3 is oily fish. Yet, national statistics show that 2 out of 3 adults eat no fish at all. For those who don’t eat fish, omega-3 supplements are available and for vegans, algae oil is a great alternative.
Supporting nutrients are those from the B group of vitamins, choline, and zinc. Studies show that low levels of B vitamins can lead to symptoms of brain fog including memory problems and difficulty concentrating. Choline is essential to produce acetylcholine, the neurotransmitter that works on memory and learning. Low zinc levels are linked to memory problems and foggy thinking. A mushroom omelette, a prawn salad, a wholegrain pitta with hummus and grated carrot are all suggestions to boost your levels of these important nutrients.
Muscle pain
Muscle pain, known as myalgia, is believed to be the result of inflammatory molecules released by immune cells in response to the virus. As inflammation is implicated, omega-3 fats in the form of fish and/or supplements are important. Other nutrients to focus on include calcium, vitamin D, magnesium and potassium.
You will find calcium in many foods including dark green leafy vegetables, seeds (especially sesame seeds) and in dairy products as well. However, it would be advisable to supplement vitamin D alongside because it improves calcium absorption.
Whilst sunshine is the best source of vitamin D because that’s the easiest for the body to convert to the hormone vitamin D, it’s quite difficult to get enough sunshine living in the UK and certainly at this time of year. Some foods contain vitamin D and these include fish, egg yolk, dairy products as well as fortified foods but supplements are necessary for many, especially during these cooler, sunshine-free months.
A diet rich in a wide variety of vegetables, nuts, seeds and pulses will contribute to your intake of magnesium and potassium too. So, for those experiencing muscle pain, meals and snacks such as watercress soup, rocket/baby spinach salad with tinned sardines or yoghurt, seeds and berries would be recommended.
Key messages: Some simple but powerful nutrition interventions could really help with your symptoms of long COVID. Try to focus on:
3 regular meals per day
Low GI foods
Healthy snack pots (ideally pre-prepared)
Specific nutrients - omega-3 fats, vitamins B, C & D, magnesium, potassium, choline and calcium
Jenny
Jenny Tschiesche BSc(Hons) Dip(ION) FdSc BANT
The Lunchbox Doctor
Best Selling Author and Nutrition Workshop Facilitator
BANT Registered Nutritionist
A note from Beingwell: If your organisation would like Jenny to deliver a workshop, or want to find out more about the many ways she can help your employees to eat better, pop us an email hello@beingwellgroup.com. Find out more about Jenny here.
References:
Anaemia and iron metabolism in COVID-19: a systematic review and meta-analysis (2020). PubMed.
Beating long COVID 'brain fog' (2021). Bangor University.
Inflammatory Leptomeningeal Cytokines Mediate COVID-19 Neurologic Symptoms in Cancer Patients (2021). Cancer Cell.