"REPURCUSSIONS OF COVID-19 WITH SPECIAL REFERENCE TO MANAGEMENT IN DIETARY PRACTICES OF VARIOUS INDIVIDUALS"
Dr. Jauhari Richa
P.hd, Govt. M.H. College of Home Science and Science for women, Jabalpur 1. INTRODUCTION
The COVID-19 pandemic is posing severe threats to international health and the economy.
At the moment there is still no cure for the disease.
Alternative methods need to be found to control the spread of the virus.
COVID-19 is caused by specific Coronavirus (SARS-CoV 2). Coronaviruses primarily cause enzootic infections in animals but is capable of transferring to humans and causing infections e.g.
Severe Acute Respiratory Syndrome (SARS) in 2002.
Middle East Respiratory Syndrome (MERS) in 2012.
1.1 Symptoms of COVID-19 Include
Fever, cough, respiratory symptoms, shortness of breath, breathing difficulties, fatigue and a sore throat.
A minority group of people will present with more severe symptoms and will need to be hospitalised, most often with pneumonia, and in some instances, the illness can include ARDS, sepsis and septic shock.
1.2 Nutrition
1. Not a cure for COVID-19 but healthy patterns of eating optimize the function of the immune system, improve immunometabolism, and are a modifiable contributor to the development of chronic disease that is highly associated with COVID-19 deaths.
2. May have a positive impact on COVID-19 as it may be a way to support people at higher risk for the disease i.e. older people and people with pre-existing conditions (non-communicable diseases).
1.3 COVID-19 and Pre-Existing Conditions
Evident that certain people are more at risk for severe illness if they contract the corona virus.
1. People at higher risk are often older people and people with one or more pre-existing conditions (non-communicable diseases).
2. Global burden of pre-existing conditions is high, worldwide one in three of all adults suffer from multiple chronic conditions.
2. WHO IS CONTRACTING COVID-19?
Older people (65+ years)
Diabetes (Type 1 and 2)
Lung pneumonia
Pre-diabetes
Lung disease
Cardiovascular disease
Chronic obstructive pulmonary disease (COPD)
Cerebrovascular disease
Hypertension
Bronchitis
Emphysema
Lung cancer
Cystic fibrosis
Asthma
The world faces unique circumstances in this time, especially with regards to COVID-19 and the impact it has with regards to outcomes for people living with pre-existing (comorbid) conditions.
1. Statistics from Italy on Corona virus deaths and pre-existing conditions indicate that: 14.4% of deaths had one pre-existing condition; 21.1% of deaths had two pre- existing conditions; 60.9% had three or more pre-existing conditions.
2. Worldometers has a section on COVID-19 by Comorbidity showing current statistics.
2.1 Objectives
a. To understand the virulence of Covid-19 by the human population.
b. To follow the dietary guidelines which are necessary to prevent against Covid-19.
c. To follow the protocol required during the time when one is suffering from such pandemic situation.
3. METHODOLOGY
3.1 Dietary Management during Covid-19
Nearly 70% of the documents retrieved encouraged the consumption of fruits, vegetables, and whole grain foods. Two nutrition societies, from Italy and Spain, recommended at least 5 servings of fruits and vegetables per day. Diets rich in fruits and vegetables contain high amounts of vitamins and minerals, including vitamins A, C, D, E, and B complex, as well as zinc and selenium, which are important modulators of the immune system. In addition, fruit and vegetables are good sources of water, antioxidants, and fiber, all of which play a role in the control of hypertension, diabetes, and weight gain, some of the most important risk factors for COVID-19 complications.
Micronutrients contribute to immune function through a variety of pathways in both innate and adaptive immune responses. Vitamins A, C, D, E, B6, and B12 and zinc are important for the maintenance of structural and functional integrity of physical barriers (eg, skin, gastrointestinal lining, respiratory tract, and others) as well as for the differentiation, proliferation, function, and migration of innate immune cells. Meanwhile, vitamins C and E, along with zinc and selenium, protect against free radical damage during increased oxidative stress. Vitamins A, C, D, E, B6, and B12 and zinc and selenium support the adaptive immune response by influencing the differentiation, proliferation, and normal function of T and B cells. These nutrients also affect antibody production and function, contribute to cell-mediated immunity, and support the recognition and destruction of pathogens. Lastly, they have antimicrobial activity and regulate the inflammatory response.
3.2 Dietary Supplementation
It is important to note that Dietary Reference Intakes have been established for healthy individuals and are based on a diet providing 2000 kcal/d. Thus, healthcare professionals should individualize dietary plans by considering factors that can increase nutrient requirements, such as specific diseases/conditions, medications, dietary patterns (e.g., vegetarianism), and exercise intensity.
The Brazilian Association of Clinical Nutrition reported that vitamin C supplementation may be useful for individuals at risk of respiratory viral infections.
Vitamin C is a recognized antioxidant nutrient that can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and, ultimately, microbial killing. However, a systematic review involving 10,708 participants showed that doses of vitamin C exceeding 1 g/d were not beneficial in reducing the incidence of colds among the overall population. On the other hand, such doses might be effective in reducing the duration of colds by 8% to 18%. In addition, vitamin C may be useful to prevent the development of colds in people exposed to brief periods of intense physical activity or to cold temperatures.
Vitamin D is another antioxidant that has been associated with a reduction in pulmonary infections. Evidence that vitamin D can prevent or treat influenza is inconclusive, but vitamin D status has been associated with the severity of COVID-19.
Potential mechanisms include increased secretion of antimicrobial peptides, decreased
production of chemokines, inhibition of dendritic cell activation, and altered T-cell activation.
3.3 Food Hygiene
Approximately 54% of the documents selected for this review included guidance on food hygiene. There is currently no convincing evidence that food or food packaging is associated with the transmission of COVID-19. The risk of faecal-oral transmission, while low, can persist even after viral clearance from the respiratory tract. This highlights the need for routine stool testing and transmission-based precautions for hospitalized patients and probably for those recovering at home. All documents emphasized the importance of adequate personal hygiene when handling food, highlighting the need for frequent hand washing with soap and water or alcohol-based hand sanitizers.
In food and beverage stores, the greatest risk of contamination is through contact with other people and “high touch” surfaces such as food scales, shopping-cart handles, and elevator buttons. Unlike some viruses that can live on food or other surfaces for several days, SARS-CoV-2 can survive on metal or plastic surfaces for 3 days and on cardboard surfaces for 1 day. Infectious disease authorities in several countries are recommending the use of soap or alcohol-based hand sanitizer for hand washing, reinforcing the importance of strict hygiene measures to prevent the spread of contamination.
According to the European Food Safety Authority, there is no need to disinfect food packaging itself, as long as some precautions are taken: (1) wash hands for 20 seconds with soap and water before and after grocery shopping, unpacking foods, and after receiving delivered food; (2) maintain a safe distance (1 to 2 meters) from other people when shopping; (3) do not go shopping when sick; instead, when possible, order groceries online or have family members or friends help with shopping; (4) avoid touching foods unless you plan to buy them; (5) limit trips to the supermarket by planning meals; (6) cover your mouth and nose with a tissue or your sleeve when coughing or sneezing, and wash hands afterward; and (7) after touching surfaces, avoid touching your face, nose, and mouth until after hands have been washed.
In contrast, the Brazilian Association of Clinical Nutrition advocates the use of hygiene practices when handling food packaging of purchased items. They recommend washing food packages with soap and water and spraying with 70% alcohol or a chlorinated solution before storing them. Fresh foods such as vegetables and fruits can be frozen after they are sanitized with sodium hypochlorite. Blanching of vegetables is also suggested to reduce spoilage.
The Food and Agriculture Organization of the United Nations proposes the use of 5 core messages for safer food: (1) keep food clean; (2) separate raw and cooked foods; (3) cook food thoroughly; (4) keep food at safe temperatures; and (5) use safe water and raw materials. Although SARS-CoV-2 can survive in water for a short time, the European Food Information Council has noted that the virus has not been detected in drinking water, which is generally subjected to several treatment steps, making both tap water and bottled water safe for human consumption and food hygiene. The main concern lies in low- to middle-income countries, where access to treated water may be limited or nonexistent.
4. SUMMARY AND CONCLUSION
This review summarizes recent scientific literature and existing recommendations from national and international nutrition agencies on an optimal diet, vitamin and mineral supplementation, and good hygiene practices for food preparation during the COVID-19 pandemic. The findings can be used to help dietitians and healthcare professionals better address dietary recommendations during the COVID-19 pandemic.
Guidance related to the safe handling of food, from production to consumption, is critical to reduce the risk of viral dissemination. The general recommendation is to consume a diet based predominantly on fresh foods such as fruits, vegetables, whole grains, low-fat dairy sources, and healthy fats (olive oil and fish oil) and to limit intakes of sugary drinks and processed foods high in calories and salt. Dietary supplements (i.e., vitamins C and D, zinc, and selenium) should be administered to individuals with, or at risk of, respiratory viral infections or in whom deficiency is detected. Breast milk is the safest and healthiest
food for infants, and breastfeeding should be encouraged, even in women diagnosed with COVID-19.
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