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Eat a balanced diet and exercise
As the people of Sri Lanka face long days and nights of restriction in their homes, Consultant Clinical Nutritionist Dr. Ranil Jayawardena offers important advice on infection preventive strategies, diet and more.
This advice follows a systematic literature review carried out by him which is due to be published in the prestigious international journal, the European Journal of Clinical Nutrition.
Dr. Jayawardena who is also a Senior Lecturer at the Department of Physiology, Colombo Medical Faculty, shares his insights for the benefit of Sunday Times readers.
The most important preventive strategy in the face of the COVID-19 danger is physical distancing, hand-washing and wearing a face-mask, he reiterates.
- Can the new coronavirus be transferred through food?
Dr. Ranil Jayawardena
Although questions have been raised in this regard, there is currently no evidence to suggest that COVID-19 can be transmitted through food or water systems. However, sharing of food and beverages is discouraged. If you have symptoms of respiratory illness, you should avoid preparing food for others.
Before preparing or eating food, it is vital to wash your hands with clean water and soap for a minimum of 20 seconds.
- Is there special food to boost the immune system?
Currently, there is no cure, super food or traditional food to boost your immune system. All these claims are fake. They may cause more damage than benefit.
- Then, why is nutrition important?
There is no cure or drugs for COVID-19. Your best weapon is prevention. It is well-recognized that nutrition is a crucial factor in modulating immune homeostasis (the mechanism through which stability is maintained), as protein-energy malnutrition or sub-clinical deficiencies of even one micronutrient, may impair a person’s immune response.
- How do you achieve proper nutrition?
It is essential to follow basic dietary advice – have a balanced and varied diet. Try to incorporate all food groups. You need to eat healthy food, not just biscuits and starchy foods.
Your meals should include cereal (preferably a high-fibre variety such as unpolished rice); protein – meat, fish especially oily fish, egg or pulses (at least two portions a day); and vegetables – leafy, non-starchy, frozen (at least three portions). Your intake should also include fruit – fresh, dried, frozen or juices (at least two portions a day) and milk – fresh, powdered, cured, yoghurt (two portions per day), while cutting down on fats, sugar and salt. The portion size and number may vary on an individual basis.
- Who is at high risk due to low immunity?
Someone with malnutrition especially the elderly, vegetarians or those who have restricted food intakes need to be extra-careful.
Elders need to be extra cautious as they may not feel hungry and thirsty and those around them need to be vigilant. Such persons may be underweight or have nutritional deficiencies due to a low intake of food and a low absorption of food into their systems.
If they are underweight, there is a need to maximize the food intake, while taking oral nutrition supplements (commercialized powdered formulas) and multi-vitamin mineral capsules/syrups. The vitamins and trace-elements which are important for optimum immunity are Vitamins A, C, D, some B and minerals such as zinc and selenium. However, a Vitamin E supplement, which some may be taking for hair growth etc., may be harmful.
For those who are in quarantine and may not be spending much time outdoors, it would be good to take Vitamin D supplements (at least 5000IU/day).
Taking multi-vitamins for a short period at least during this epidemic may be beneficial, since most of us do not have a well-balanced and varied diet due to several logistical and financial difficulties during curfew and quarantine.
- Is there any food that may increase immunity?
During our literature search, we found that several nutraceuticals and probiotics have special properties to improve immunity against viral infections such as the coronavirus. These included garlic, oily fish and cranberry juice. The probiotics include Lactobacillus and are found in yoghurt and curd.
Any other reason why healthy nutritional habits should be encouraged during this epidemic.
Yes. If you are overweight, obese, have diabetes or cardiovascular disease (CVD), you are not at increased risk of developing COVID-19, but if you do contract the disease, you may be at risk for more severe symptoms and disease progression. People with diabetes, which is highly prevalent in Sri Lanka, need to be extra careful and follow dietary advice and their medication regimen to the letter.
- What else will help maintain a healthy immune system?
A. Hydration: water, other drinks such as tea and herbal drinks at least 2-3 litres per day, especially for those in quarantine.
Exercise: regular but a modest level of exercise is encouraged, for about 30-60 minutes per day. Avoid very aggressive, extreme exercises, which may reduce the immunity.
Reiterating that this is a challenging time for all, Dr. Jayawardena says that we should look at the positive side in these circumstances.
“Whereas earlier many families did not have time to sit and eat together, now has come the chance to do so. Parents and children can enjoy a healthy meal while discussing the importance of including vegetables in it. New recipes can be tried out,” he says, adding that as far as possible stick to a routine, getting up at a particular time, having meals at a regular time and going to bed at a particular time. Do some exercise, participate in household activities and indulge in hobbies.
| Don’t smoke or drink alcohol | |
| Many are the queries and also the jokes about smoking and drinking in the light of COVID-19. Smoking is a clear ‘No, no’, stresses Dr. Ranil Jayawardena, explaining that there is evidence that those who smoke get more severe disease and have a higher chance of dying of COVID-19, due to the involvement of the respiratory tract and lungs in this disease. The consumption of alcohol too clearly reduces a person’s immunity. Therefore, in addition to other known risk factors in the case of COVID-19, it is strictly prohibited, he adds. |
| COVID-19 & trauma on the mind | |
 Prof. Raveen Hanwella The COVID-19 pandemic has devastated the social and economic life of almost all the countries and will invariably impact mental health, says Prof. Raveen Hanwella, Chair Professor of Psychiatry at the Department of Medicine, Colombo Medical Faculty. He says: “Usually when I write on such matters, I base my statements on established research. But in this situation, there is no precedent and I can only speculate on what might be extrapolated from research which has relevance to the current crisis. “A year ago, after the Easter Sunday bomb blasts, I wrote on the effects of trauma on the mind. I talked of post-traumatic stress as well as post-traumatic growth. Some of these may be relevant at this point as the threat of contracting a potentially lethal virus is indeed a stress of some magnitude. “It is compounded by the fact that the threat is invisible to the naked eye and is continuous. The most obvious is increased levels of anxiety or stress. In addition, the measures taken to contain the pandemic such as social distancing, lockdowns and curfews and the disruption of travel and the routine work structure will increase loneliness and depression, with a possible increase in self-harm and suicide.”
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