Clinical update

COVID-19 nutritional advice

The Managing Adult Malnutrition in the Community team has co-produced nutritional advice to help patients during and after experiencing COVID-19 and aid their recovery

Home nutrition
Picture: iStock

Essential information

Since a new coronavirus emerged in China late last year, the COVID-19 illness it causes has swept around the world. While for many people it will causes minor symptoms, some people, including older people, people with long-term health conditions and pregnant women, are at higher risk. The main symptoms are a high temperature and a new, continuous cough.

View our COVID-19 resource centre

What’s new?

Nutritional advice to help patients during and after experiencing COVID-19 has been published to aid their recovery.

The Managing Adult Malnutrition in the Community team has worked with the British Dietetic Association (BDA) and the British Association for Parenteral and Enteral Nutrition (BAPEN) to develop a range of patient information leaflets.

The leaflets are tailored to how severely unwell a patient has been, with ‘red’ aimed at those who have been very unwell, recently discharged from hospital, and who are struggling to eat enough, or are underweight or have lost weight due to their illness.

This information leaflet gives practical advice on increasing nutritional intake and how to incorporate oral nutritional supplements into the diet if they are prescribed. Advice includes tips on eating enough protein, how to eat when breathless and when experiencing a dry mouth.COVID-19 leaflet on nutrition

The yellow leaflet is aimed at those who have a poor appetite or recent unintentional weight loss from COVID-19, and the green leaflet focuses on eating a balanced diet to help maintain strength and fitness and help the body fight infection.

A tool has been published to help people work out which publication will be most suitable for them.

The leaflets are clear that there are no specific foods, vitamin or mineral supplements that will prevent someone from catching COVID-19 but emphasises that eating a well-balanced diet can help support the normal functioning of the immune system.

Dietary advice for people who have or have had COVID-19 illness needs to be considered in relation to a number of factors including severity of their illness, any underlying conditions they have, whether their appetite has been affected and if they are overweight or underweight.

The organisations say that those who received intensive care would need individualised dietary advice from a registered dietitian.

Expert comment

Liz AndersonLiz Anderson, nurse representative on the Malnutrition Pathway Panel and BAPEN executive officer
‘COVID-19 is affecting many older people who have co-morbidities and underlying health conditions. Therefore if they do go into hospital they will probably already have not eaten or hydrated well for a number of days. No matter how good the treatment and care, if patients don’t get the right nutrition they are not going to get a good outcome. So when a nurse sees a patient in a community or hospital they need to use their assessment skills and carry out appropriate screening, such as the Malnutrition Universal Screening Tool (MUST).

'Someone who is obese should not be left out of such assessments, as they could be lacking essential micronutrients which will affect their response to treatment and recovery. If the equipment for weighing is not available, there are other assessment tools on the BAPEN website. These leaflets are perfect for someone to take home when they are discharged. It is especially important for a patient who has been in ITU as it takes a long time to reach any sort of normality after that.’  

 

Key points for nurses

  • BAPEN encourages all nurses to continue to routinely screen for malnutrition with the MUST. If it is not possible to take physical measures of weight or height, then there are a series of alternative measures that can be used.
  • Encourage patients to keep an eye on their weight to see if it is changing. If people are unable to weigh themselves, they can check other signs of weight loss, such as jewellery or clothes becoming looser.
  • Patients can check to see if they are at risk of malnutrition by using the self-screening tool found here.
  • Changes to taste and smell are common symptoms of COVID-19 and can make eating and drinking less enjoyable. Patients should experiment with herbs, spices, pepper, chutneys and pickles in cooking. If they are struggling with the strong taste of hot foods, try cold foods instead.
  • Encourage people to eat smaller meals with snacks and nourishing drinks (e.g. smoothies, soups, fruit juice, milkshakes or hot chocolate) in between.
  • Also to avoid drinking before or during meals, as the liquid can fill up people with small appetites.

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