Is what I eat affecting my recovery?

You may be more at risk of nutritional problems if you answer yes to any of these questions:

• Do you have on-going symptoms (such as poor appetite, sore mouth, tiredness)? If these persist after you had COVID-19 they may affect your diet, or you may be able to improve them by altering your diet. See this page for more information on managing your symptoms. Having symptoms for more than 12 weeks is called post-covid syndrome and you should consider seeking further advice from your healthcare professional.
• Do you have high blood pressure, diabetes or a high body mass index (BMI) (over 30)? This means you may have been affected more by COVID-19 and need to adapt your diet to manage these conditions too.
• Were you hospitalised as a result of COVID-19? This suggests you had a much more severe infection, and you may need more help to recover. Ideally you would be offered follow-up appointment from a dietitian, COVID-19 clinic, GP, or consultant one to two months after discharge.
• Are you using an oral nutritional supplement (such as Ensure, Glucerna, Boost Isocal, Foodlink, Fortisip, Aymes or similar) with the aim of improving your COVID-19 symptoms? It is important your healthcare professional checks the supplements are working and how long you need to stay on them.

If you have answered yes to any of these it is important to get nutritional support. The section below explains how.

In the next section you can find self-screening tools and a checklist to help you identify specific nutritional problems.

Your symptoms may change over time and the dietary advice may change too. Consider coming back to this page to check your risk at intervals.

Here are some tools designed to identify risk of under-nutrition. If you think you have a specific vitamin or mineral deficiency, you will need to consult a registered nutrition expert or your GP. 

Have your eating habits or diet changed since catching COVID-19?

Changes in eating habits or lifestyle can mean your nutrient intake alters. This online tool from the BAPEN Malnutrition Self-Screening website can help you find out whether you are at nutritional risk. If you have noticed weight change (loss or increase), or if any of your symptoms affect what you eat, use this self-screening tool.

The tool asks about weight change – If you can’t remember your weight before or unable to weigh yourself now, just think about whether your clothes, belt, rings or watch strap have become looser or tighter; this is a sign of weight change. Similarly, dentures can become loose with weight loss.

Do I need a nutritional assessment?

The Patient Association Nutrition Checklist can help you understand whether you need dietary advice and a more detailed nutritional assessment. You can download it from the Patient Association website [PDF]. The checklist gives a guide for signs that you may need help and provides information about how to find it.

My swallowing is sometimes difficult, is there a tool to assess this problem?

If you have problems with swallowing, you can download a self assessment from the Melbourne ENT Group website [PDF]. If your score is 3 or higher you may want to seek a consultation with a speech and language therapist or dietitian. Ask your GP for a referral.

I have post COVID syndrome, do I need nutritional support?

The multi-disciplinary-rehabilitation teams from Leeds, Airedale and Hull NHS Trusts have produced a screening tool called COVID-19 Yorkshire Rehabilitation Screening (C19-YRS). It assesses symptoms and guides what support you might need. There are questions about swallowing and nutrition. You can find the tool on their website. If you have concerns about diet, weight loss or swallowing seek further support via your GP, local post COVID clinic or other health professional.

Useful links

Find a dietitian or nutritionist
How to find high quality advice and support to help your COVID-19 recovery

BAPEN Malnutrition Self-Screening website
Online tool to help you find out whether you are at nutritional risk

Nutrition Checklist
The Patient Association checklist can help you understand whether you need dietary advice

If you need nutritional advice and support, contact one of the following for help:

• Your GP – you can ask for referral to see a dietitian
• Your local hospital – they may offer follow-up appointments or a post-covid clinic. The dietetic department may take self-referrals. You will have to check locally.
• A dietitian or a registered nutritionist – for information to help you find a dietitian or nutritionist, please see our Find a dietitian or nutritionist to help your COVID-19 recovery page.

These are the type of things that they can help you with:

• A source of advice and support
• Signpost you to support groups, a link worker (if this is available) or online apps
• Help you get support from local services, the Department for Work and Pensions and advice about financial support
• Written information as a reminder of what was discussed
• Tailored advice for managing specific symptoms like breathlessness, fatigue or brain fog
• Additional support if you are self-isolating, lonely, recently bereaved or other issues.

You can listen to the talk about “Psychological well-being and communication with health professionals” to learn more about how to make the most of your consultation with a healthcare professional.

Useful links

Nutrition Checklist
The Patient Association checklist can help you understand whether you need dietary advice

BAPEN Malnutrition Self-Screening website
Online tool to help you find out whether you are at nutritional risk

The Eatwell Guide
How much of each food group we need to achieve a healthy, balanced diet

TALK: Psychological wellbeing and communication
Managing long COVID symptoms from both a mental and physical perspective

TALK: Is there an anti-inflammatory diet?
What are the links between diet and immunity, and can diet help to reduce inflammation?

The first step would be to make sure you are following healthy eating guidelines which can be found in The Eatwell Guide.

The evidence also suggests that a Mediterranean style diet is highly beneficial. This includes:

• wholegrain breads
• fresh vegetables and fruits
• fish and seafood
• nuts, seeds, legumes and potatoes
• herbs and spices
• healthy fats: extra virgin olive oil, avocados, olives and avocado oil
• yogurt, eggs, cheese and poultry which should be eaten in moderation.

New evidence

An observational study from Vietnam surveyed almost 4,000 outpatients with COVID-19 like symptoms (but tested negative). The results showed that eating more vegetables, fruits and fish was related to a lower likelihood of presenting COVID-19 like symptoms (and possibly chronic inflammatory diseases). This evidence suggests that a diet high in these foods (like the Mediterranean diet) could be helpful in avoiding some COVID-19 symptoms (Nguyen et al., 2021). Eating more fruit, vegetables and fish is advised for a healthy diet.

The ZOE COVID symptom study examined the self-reported diet of almost 600,000 people, and found that a plant-based diet related to lower severity of COVID-19 symptoms. However, the information in this study comes from higher socio-economic status individuals, which limits who the results apply to. Nevertheless, the data suggest that if healthy diets can be followed, reduced COVID-19 symptom severity may be achieved. A diet high in plant-based foods includes most of the key nutrients involved in the optimal functioning of the immune system (vitamins A, B6 , B12, C, D, and E, and folate, amino acids, long-chain omega-3 fatty acids (docosahexaenoic and eicosapentaenoic)) and a category of compounds naturally found in plant such as polyphenols (Merino et al., 2021).

 

You can listen to the talk “Is there an anti-inflammatory diet?” which discusses the Mediterranean diet in more detail.

You can also listen to the talk “Is there a link between food and my symptoms?” which explains how to monitor your symptoms and possible dietary changes you could make.

There are two other talks that you may find interesting: “Diet and COVID” and “Q&A panel with our experts”. Find details about all our talks.

Nutrition and COVID-19 Recovery – a series of talks

TALK: Is there a link between food and my symptoms?
How to monitor your diet, link symptoms to food, and use a food diary effectively

TALK: Diet and COVID
From disrupted dietary and lifestyle habits to diet related risk of COVID and managing long term symptoms

TALK: Q&A panel with our experts
Our panel of experts return to answer questions that viewers posted following the talks

Discover the full series of talks
Our experts aim to answer questions on what to eat and why. We also look at how to check and manage your diet and health

• Merino, J. et al. (2021) ‘Diet quality and risk and severity of COVID-19: a prospective cohort study’, Gut, 70(11), pp. 2096–2104. doi:10.1136/gutjnl-2021-325353.

• National guidance for post-COVID syndrome assessment clinics (6 November 2020) [Internet]. Patient Safety Learning - the hub. [cited 2021 Jan 9]. Available from: https://www.pslhub.org/learn/coronavirus-covid19/guidance/national-guidance-for-post-covid-syndrome-assessment-clinics-6-november-2020-r3465/

• Nguyen, M.H. et al. (2021) ‘Single and Combinative Impacts of Healthy Eating Behavior and Physical Activity on COVID-19-like Symptoms among Outpatients: A Multi-Hospital and Health Center Survey.’, Nutrients, 13(9). doi:10.3390/nu13093258.
  

• University of Leeds, Sivan M, Halpin S, University of Leeds, Gee J, Airedale NHS Foundation Trust. Assessing long-term rehabilitation needs in COVID-19 survivors using a telephone screening tool (C19-YRS tool). ACNR. 2020;19(4):14–7.