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what to eat in the time of coronavirus?

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Of Simona Bertoli

Head of the Obesity Unit and Nutrition and Obesity Research Laboratory, Department of Endocrine and Metabolic Diseases IRCCS Istituto Auxologico Italiano

Associate Professor of Food and Dietetic Sciences, Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan

Coordinator of the Outpatient Nutrition Service, International Center for the Evaluation of Nutritional Status, ICANS, University of Milan

What to eat in the time of Covid-19?

It's one of the frequent questions on the web these days. To give a scientific answer to this question, it is necessary to divide the question into two:

– Is there a diet that helps us defend ourselves or improve our response to infection?

– How must our diet change following the large and rapid change in lifestyle resulting from the restrictions decided by the latest Prime Minister's Decree?

To the first question it is important to clarify that we do not have a specific answer to Covid-19. It is obvious, we have only known this new virus for a few weeks, we know very little about its biological characteristics, there are no studies on possible pharmacological treatments, there is no scientific evidence available on which foods or nutrients are able to improve our immune defenses to prevent or fight this infection.

However, the possibility of modulating some of the functions of the immune system through the intake of specific nutrients or foods rich in functional nutrients has been extensively studied in recent decades. In particular, immune-stimulating properties have been demonstrated for some vitamins (Vit. A, C, E and D), for some micronutrients such as zinc and selenium and more recently for probiotics.

Over 140 animal studies suggest that vitamin C can prevent or relieve the symptoms of infections caused by bacteria, viruses and protozoa. The most studied human infection is the common cold where regularly administered vitamin C appears to reduce the duration of symptoms, indicating a biological effect. Only two controlled studies have found a therapeutic benefit of vitamin C for patients with pneumonia therefore to date, the effects of vitamin C against infections need to be further investigated (Hemilä 2017).

In recent years, numerous studies have been aimed at the possible role of vitamin D following the discovery of its numerous extraskeletal effects, and no relevant impact on innate and adaptive immune responses has been demonstrated. According to most authors, further studies are needed to explore the preventive effect of vitamin D supplementation on viral infections (Gruber-Bzura 2018).

Among the minerals, the most studied in the immunological field is Zinc. It has been demonstrated, in studies in animal models and in humans, that its deficiency can lead to alterations in the integrity of the immune system (Dardenne 2002). A marginal deficiency has been observed in several “at risk” population groups, such as the elderly, supporting the hypothesis that supplementation in the most vulnerable subjects could prevent the compromise of the immune system and substantially improve resistance to infections in these subjects.

More recently, scientific interest has been turned to probiotics which in addition to having a specific role in the regulation of the intestinal microbiota appear to have an immunomodulatory effect. Among probiotics, β-glucans are the most studied, and the best known effects derive mainly from studies carried out on animals and consist in the increase in phagocytosis activity and the activity of natural killer cells (Akramienė 2007).

Where do we find these nutrients? Our Mediterranean-type dietary modelcharacterized by the abundance of plant foods such as bread, pasta, vegetables, legumes, fruit and dried fruits, olive oil as a primary source of fat, moderate consumption of fish, white meat, dairy products and eggs, moderate quantities of meat red wine and modest consumption of wine during meals, provides an optimal supply of all the “functional” nutrients that can play an immunomodulatory role, leaving the use of supplements to cases in which a deficiency state can be hypothesized.

How should our diet change after the “I stay at home” decree?

The #IORESTOACASA Decree has numerous important consequences that can influence our energy needs and our eating behavior in particular:

– the reduction in daily motor activity, as a consequence of smart working, the closure of gyms and sports associations, the invitation to only essential travel and, for children, the closure of schools and all recreational sports activities has led to a significant reduction in daily energy needs. For example, a 40 year old man with a weight of 73kg and a height of 180cm and with a moderately active lifestyle has an estimated energy requirement of between 2730 and 2990 kcal per day which becomes 1710 -2480 kcal per day day if the lifestyle becomes sedentary (LARN, 2014). That's 500-1000 kcal less per day which should correspond to a corresponding reduction in food consumption;

anxiety, stress and boredom that can occur at this moment can favor the appearance or worsen, in those who already suffer, the so-called “emotional eating”, i.e. the use of food as a compensation mechanism through which to regulate and reduce negative emotions. This alteration of behavior leads to the consumption of food that is generally rich in sugars and fats and therefore high-calorie, with a high glycemic index and a high quantity of cholesterol (Marieke 2011);

the need to reduce the opportunities to go out to do the shopping it induces a greater consumption of preserved foods, generally with a higher sodium, fat and preservative content and a lower availability of fresh fruit and vegetables, overall worsening the quality of the diet.

What consequences?

The consequences are an increased risk of increasing body weight and in subjects already suffering from overweight, obesity, diabetes and metabolic syndrome a worsening of the clinical picture.

What to do?

Implement physical activities in house using exercise bikes, treadmills or relying on the many tutorials on the web where exercises are suggested to be carried out without particular tools.

Cooking with imagination following the Mediterranean model and increasing the consumption of fruit and vegetables to at least 5 portions to ensure the correct consumption of vitamins, minerals and functional nutrients and reducing caloric intake, increasing physical activity, cooking or implementing other recreational activities will be It is also of great help in combating emotional eating.

Bibliographical references

Akramienė D, Kondrotas A, Didziapetriene J, et al. Effects of β-glucans on the immune system. Medicine (Kaunas) 2007:43;597-606

Dardenne M. Zinc and immune function. Eur J Clinical Nutr 2002;56(Suppl 3):S20-3.

Hemilä H. Vitamin C and Infections. Nutrients. 2017;9(4):339. Published 2017 Mar 29.

Gruber-Bzura BM et al Vitamin D and Influenza-Prevention or Therapy? Int J Mol Sci. (2018)

Reference Intake Levels of Nutrients and Energy for the Italian Population (LARN), 4th ed. 2014. Italian Society of Human Nutrition (SINU)

Marieke A. Adriaanse, Denise T.D. de Ridder & Catharine Evers (2011) Emotional eating: Eating when emotional or emotional about eating?, Psychology & Health, 26:1, 23-39, DOI: 10.1080/08870440903207627

Further Information and Updates on 2019 nCoV

For more detailed information on the new Coronavirus, on correct prevention, on infections in Italy, on the rules to be respected and on quarantine methods, we recommend reading the dedicated articles:

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