Dietary Recommendations During the COVID Pandemic

 By Kathy Shattler, MS, BS, RDN

As countries struggle to enforce guidelines to prevent the dreaded coronavirus spread, social isolation widens with a growing sense of sadness and depression. As countries implement self-quarantine and temporarily close businesses, regular food-related practices are inevitably affected. Changes in diet and a lowering of physical activity during quarantine increase our risk of heart disease. 
Everything from how we eat at home to shopping in grocery stores and dining in restaurants has reached new normality. Optimal nutrition can indeed increase our sense of well-being and enhance our immune system. So, how do we do that in this new normal?
How to Eat Healthy in Quarantine
Eat Adequate Fiber: Fiber is the indigestible part of food that helps our intestines flush out food, keep our bodies regular, satiate the appetite, and even lower blood cholesterol and glucose. 
There are two primary types of fiber, water-soluble and water-insoluble. Insoluble fiber includes cellulose, hemicellulose, and lignin obtained mostly from whole wheat, wheat bran, nuts, and vegetables. It helps with hydration and gastrointestinal regularity.
Soluble fibers help control appetite, lower cholesterol and blood sugar, promotes regularity, and helps with hydration. Soluble fibers are found in oats, fruits, legumes, barley, some vegetables such as sweet potato and psyllium.
The amount of daily fiber to eat should be 25-30 grams per day. Currently, dietary fiber intakes average about 15 grams per day, which is not enough. Eating more fruits, vegetables, and whole grains will boost that amount without a need for a fiber supplement.
Get Adequate Fluid:  Most of us just plain do not get enough water-from food, from tap water, from juices, milk, or coffee. Yes, it can all be counted towards our fluid allowance, but we still don't hit the mark. Inadequate fluid can cause headaches, dry skin, dizziness, irregularity, and a tired feeling. 
The U.S. Academy of Sciences recommends that males drink 15.5 cups of fluid per day and women drink 11.5 cups per day. Children and teens need 6-8 cups of liquid per day, and an increase should be taken if exercising. When exercising, drink .5-2 cups of water every 15-20 minutes, especially if sweating or in high heat.
Get five servings of fruits and vegetables. Most government agencies have advised us all to increase our intake of fruits and vegetables during the pandemic. Not only do they contain the needed fiber, but they contain essential vitamins and minerals to keep our immune system healthy and in good shape to fight off viruses. They are also a good source of vitamin C and vitamin A, two essential immune system nutrients.
Don't hoard junk food. People have misunderstood, and government agencies have been downright wrong to suggest that we stock up on highly processed junk food that may not go bad but are not good for our health either. They also do not help the waistline. Gaining weight during the pandemic has been one of the downfalls of this whole ordeal, and dining on pop tarts, snack crackers, and juice packs is not in our best health interests and indeed not suitable for calorie control.
Supplements need not be taken to remain healthy but may be beneficial: There is no data to suggest that taking a supplement will prevent COVID or guarantee recovery.
There is observational data and some randomized control studies starting on the use of vitamin D in COVID as vitamin D has been shown observationally to benefit the recovery of COVID infected patients. Furthermore, supplementation has been recommended for high-risk groups. Since almost 50% of the nation is deficient in vitamin D, it is advised that blood levels be obtained and if deficient, a repletion supplementation program started with optimal maintenance doses taken after that to keep the immune system functioning at its best.
It is important to note that the Recommended Dietary Intakes are based on a 2000 calorie diet, and many people do not get that many calories, especially our at-risk elderly. In these cases, supplementation may be beneficial to get the minimum daily requirements of essential nutrients, particularly selenium, zinc, and vitamin A. Although it is preferable to get nutrients and antioxidants through food, this is not always possible.
Supplementation with vitamins C and D and possibly zinc and selenium may be potentially beneficial for those at risk of respiratory infection or who are deemed deficient in these nutrients. At-risk people for vitamin D supplementation are those with dark skin, the elderly, or those confined to a nursing home.
Do not stress snacks. The pandemic is a period of increased stress. We have to wear masks, distance ourselves, practice scrupulous hygiene, and worry about getting sick. It's stressful. What do we tend to do when we are stressed? Eat. Try mindful eating. Ask yourself, am I really hungry or just bored or stressed? Have a list of alternative activities ready to do so you aren't putting that fork in your mouth. Now is the time to start a home exercise program to dispel that pent-up energy from stress.
Avoid processed foods. If you are home more, try cooking more home-cooked meals, so you know what is in the ingredients. You aren't eating a bunch of sodium you don't need or flavorings, additives, and preservatives that only stress your body out more and are devoid of necessary antioxidants and essential nutrients.
How to Shop Healthy in Quarantine
Keep your distance when possible, and wear your mask if medically possible. Avoid touching a product unless you are going to buy it. Make use of the hand hygiene stations and disinfect your cart before using it. Plan your shopping list around meals before you get to the store. Plan your list in the order that the products are displayed in the grocery store. Read labels. Shop for healthy oils such as olive oil.
Wash your hands when you get home from the store and after taking care of the groceries. Do not use disinfectant on your produce and grocery items as they can get in your food, but you can wipe down food containers. 
Is it Safe to Order Food from Restaurants?
Currently, there is no evidence of transmissibility from food containers or food from restaurants. Practicing good regular hygiene and order-cooked meats, try to keep hot foods hot and cold foods cold. Many food places have instituted the no-touch policy where they don't contact the food or the clients. Coronavirus is destroyed at temperatures of 132.8-149 degrees F.  If you get food contaminated with coronavirus, your stomach acid will deactivate it, leaving it harmless. 
Keeping Your Immune System Healthy
The increased consumption of whole grains, fruits, and vegetables should provide the needed micronutrients for a healthy immune system. The most concerning nutrients are vitamins A, C, D, zinc, and selenium, as we discussed already. These nutrients should be obtained from food if possible, but supplementation can replace what is nutritionally deficient. Antioxidants are particularly important, as are omega-3 fatty acids, both of which can be obtained from the diet. Antioxidants are high in fruit and vegetables, and omega-3 is high in fatty fish and flaxseeds.
Despite the new normal, optimal nutrition and a healthy weight can still be maintained during the pandemic. Creativity in lifestyle choices may need to be employed, and change is always hard, but not impossible.