How should NUTRITION and ACCESS TO FOOD be managed during the coronavirus outbreak?

Novel coronavirus disease (COVID-19) case numbers are rising rapidly around the world and in Turkey during these difficult days. We frequently emphasise that the most effective way to protect ourselves from this outbreak is to increase social distancing as much as possible and pay attention to personal hygiene. In addition, to remain healthy and energetic, we should not forget the importance of proper nutrition.

Note: the scientific name of the novel coronavirus is SARS-CoV-2, while the disease caused by this virus has been named COVID-19.

Nutrition during the Coronavirus Pandemic

The immune system is an effective defence mechanism that protects the body against microorganisms. To help protect our bodies against viruses, a balanced, healthy eating plan with a high nutrient content and a wide variety of foods can effectively support a strong immune system.

Some people recommend ready-made products such as vitamins, antioxidants, minerals and omega-3 as supplements during this period. However, there is no scientific evidence supporting this recommendation during the outbreak; in other words, the benefits of supplements for you will not outweigh their harms (see: vitamin and mineral supplements – what doctors and users should know).

By contrast, we recommend a diet rich in high-quality protein for physical and mental health. We should also get enough sleep, neither too much nor too little.

A study showed that the ideal sleep duration is 7-8 hours. The study observed a 17 to 24% increase in the risk of death among those who slept for less than 7 or more than 8 hours at night. Sleeping pill use also increased the risk of death by 1 in 3.

It is beneficial to include a balanced mix of vegetables and fruit, olives and olive oil, whole grains, pulses, eggs, fish, chicken/turkey/red meat and nuts in our diet.

Your plate should not consist of a single colour or a single food group. We recommend a colourful plate that includes different food groups. This will help you obtain the nutrients needed for a strong immune system.

In addition to eating a balanced and healthy diet, to remove toxins from the body, stimulate the metabolism and strengthen our immune system, it is also important to drink plenty of water and we should not neglect doing so.

Upon examining the nutritional principles recommended for protection against COVID-19, we noticed that the Mediterranean Diet closely resembles those nutritional principles.

Many studies published to date have already demonstrated a strong, positive relationship between the Mediterranean Diet and the immune system. This year, the Mediterranean Diet was again selected as the healthiest diet by US News & World Report. We can say that it is the ideal diet both for strengthening our immunity against novel coronavirus infection and for protecting against future health problems while staying fit and energetic.

Nutrition myths: time to confront anti-vaccination views and the vilification of packaged foods

Can vitamin and mineral requirements be met through food?

A balanced and healthy diet can provide your body with the minerals and vitamins it needs without taking supplements. When requirements cannot be met naturally, you can consult a nutrition specialist / dietitian or your doctor about nutritional supplements.

Are vitamin D supplements necessary?

Another molecule our bodies need, particularly for immune system and bone health, is vitamin D. However, we obtain it mainly from sunlight rather than food. Small amounts are found in oily fish such as salmon and sardines, egg yolks, red meat and shop-bought products such as breakfast cereals fortified with vitamin D during production, but these do not meet our requirements. Therefore, even with a balanced, healthy diet, the foods you eat may not meet your body’s vitamin D needs. Under normal circumstances, spending 15-20 minutes outdoors on a bright day may be sufficient. However, we need to stay at home during this stage of the COVID-19 outbreak. During these difficult days when we go outside less, vitamin D supplements may be taken after consulting a specialist. Because vitamin D can be stored in the body, there is no need to worry about this after 1 month at home. If suitable, spending 15-20 minutes on the balcony each day may also be a solution. However, we should not forget the harms of excessive vitamin D supplementation.

Related topics:

- The latest position on vitamin D and Omega-3 supplements!

- What is vitamin K2? Is it wrong to take vitamin D without K2?

- Vitamin D and cancer! Does deficiency cause cancer? Do high levels prevent cancer?

Is breastfeeding a baby unsafe?

There is currently no evidence that a mother can infect her baby through breastfeeding. In addition, children and babies are among the age groups least affected by COVID-19. Given the countless benefits of breast milk for a baby, experts say it is beneficial not to stop breastfeeding because of a risk factor that has not yet been proven. We should remember that close contact with the baby and infection through droplets are the most important risk factors.

In this case, if you have decided to continue breastfeeding your baby:

• Always wash your hands before touching your baby, breast pump or bottle.
• Because your respiratory droplets could infect your baby, avoid coughing and sneezing when near your baby and while breastfeeding.

How should we shop for food and hygiene products?

During these difficult days as we face the COVID-19 outbreak, experts frequently stress the importance of personal hygiene and avoiding contact. Many people in Turkey and around the world have turned to products such as masks, gloves and hand sanitiser and have begun taking measures to protect themselves against the virus.

At first, maintaining personal hygiene and avoiding contact as much as possible was not so difficult. As the days passed, the natural balance of life began to change: group activities, cinemas, restaurants and schools closed. Alongside personal hygiene and protection from contact, many questions then arose about how we should meet our needs.

Yes, we should avoid contact! But how can we shop for a healthy, balanced eating plan under these circumstances?

Because of the concentration of people, crowded supermarkets can be described as settings where infection risk is particularly common. However much you try to avoid contact, it will not be possible to avoid respiratory droplets from a customer who suddenly starts coughing or sneezing next to you. We can therefore say that the best way to do your grocery shopping is to order home delivery. To make the process safer for both you and the delivery person, you can avoid contact by asking for the bags to be left on the ground outside your door. According to public health experts, the risk of infection from ordering home delivery is low. Our risk of infection from contaminated items such as bags or packaged food is much lower than the risk of going to the supermarket and being infected by respiratory droplets from an infected customer.

If you cannot order home delivery and must go directly to a supermarket, choose less crowded times or quieter shops on side streets.

Following its investigations into the possibility of people becoming ill after consuming food contaminated with the novel coronavirus, Germany’s Federal Institute for Risk Assessment (BfR) points out that no cases demonstrating this link and no foodborne infections have yet been identified. However, it also notes that research and observations are continuing because this is a new virus.

For people who cannot prepare meals at home because of a health problem or another reason, it would be healthier to order home delivery from a restaurant whose hygiene standards they trust rather than visit a restaurant. As with grocery shopping, ordering food for home delivery instead of eating at the restaurant reduces the risk of infection. Experts also say that the risk of infection from cooked food is very low, provided it has not been contaminated afterwards.

Are there any miracle foods that protect against the novel coronavirus?

There is no single food or supplement that can strengthen the immune system, and there is no miracle food or diet that acts as a protective shield against COVID-19! To date, the European Food Safety Authority, EFSA, has not allowed claims that any food or ingredient protects against infection. On the other hand, situations such as a pandemic pose a risk of poor and inadequate nutrition. This brings us to the issue of food security, which we have not yet paid much attention to in the context of the coronavirus outbreak.

Will we have enough food?

Food security is defined as everyone having economic and physical access to sufficient, healthy food to maintain a healthy, active life. During periods like these, when people are working from home and some countries are even implementing quarantine measures, healthcare workers undoubtedly carry the greatest responsibility and face the hardest task. However, the food industry also has an important responsibility in trying to ensure safe food production and a secure food supply. The importance and value of the food industry, which sometimes faces unfair criticism, become clearer at times like these.

However, the issue is not only maintaining production but also keeping consumption in balance.

While keeping enough stock at home to allow less frequent shopping trips, we also need to see the other side of the coin. Stockpiling more than necessary creates imbalances in food security. Those most affected are people in higher-risk groups, such as those with limited purchasing power or mobility, people who are ill and older people. If we stockpile too much, packages of food sitting in our homes will be locked away somewhere those who truly need them cannot access. You may therefore increase the barriers preventing others in your community from obtaining enough food, and increase their risk of catching the virus because of their psychological vulnerability and immune system susceptibility. Remember that every new person who becomes ill poses a risk not only to themselves but also to you and your loved ones. This underlines the importance of buying only as much as we need.

To briefly summarise nutrition and access to food during a pandemic in 5 points:

• You can strengthen your immunity by including nutrient-rich foods such as vegetables and fruit, olives and olive oil, fish, chicken, meat, eggs, whole grains, pulses and nuts in your diet.
• If you follow the principles of the Mediterranean Diet, a healthy, balanced eating pattern, you should not need vitamin and mineral supplements. Vitamin D, which we obtain mainly through sunlight rather than food, may not be obtained in sufficient amounts. Do not worry about this: your vitamin D stores will not run out immediately. Consider spending 15-20 minutes on the balcony each day. When this is not suitable, you can consult your specialist and take a supplement of 10 micrograms daily.
• As there is no evidence that babies can be infected through breast milk, you can continue breastfeeding your baby in a sterile environment while avoiding contact as much as possible.
• You can reduce the risk of infection by ordering home delivery instead of going to a supermarket or restaurant.
• By buying only as much as you need from supermarkets to avoid exhausting supplies, you can help other consumers access hygiene products and food.