All Diet Plans

Post COVID - 19 Recovery Diet

Post COVID - 19 Recovery Diet

Subscription Plan

Plan Price
1 Month Rs. 18000

What oxygen is to the lungs, such is hope to the meaning of life.

(Emil Brunner)

 

The COVID-19 pandemic is a global emergency that has led to the implementation of unprecedented measures to stop the spread of the infection. Governments of almost every country are enforcing measures to avoid the spread of this virus, including lockdown, travel bans, home quarantine, isolation, and social distancing. These all have resulted in extended periods of time at home, reductions in physical activities and lifestyle, including dietary habits.  


This lifestyle degradation has led to the loss of muscle mass and an increase in body fat. It may also accelerate sarcopenia (decrease in muscle mass, more common in old people).  

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80


In addition to sarcopenia (muscle loss), these lifestyle changes may also lead to several chronic disorders, including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. 


These disorders and increased body fat increase the risk of COVID-19 infection and more severe symptomatology, underscoring the importance of avoiding the development of such morbidities.


Here we will discuss the mechanisms of sarcopenia (muscle loss) and its relation with physical activity, dietary habits, sleep, stress, as well as extended bed rest due to COVID-19 morbidity. 


However, these symptoms can be reduced by the intervention of several home-based strategies, including resistance exercise, higher protein intakes, and supplementation. The intervention of such strategies may also reduce the chances or can also reverse the symptoms of sarcopenia (muscle loss). It can also be beneficial for future periods of isolation. 

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80


The three main factors leading to lean muscle mass are acute illness or injury leading to prolonged bed rest, incomplete recovery, and increased age. A comparative study between people taking sleep for 5.5 hours and 8.5 hours reported that people sleeping for only 5.5 hours lost a greater amount of weight as fat-free mass (including muscle) and less body fat was lost in comparison to those taking 8.5 hours of sleep.
 

Summary of potential effects of government restriction on lifestyle behavior and the mechanism by which muscle protein synthesis is decreased and muscle protein loss is increased:

 

The mechanism by which muscle protein synthesis is decreased and muscle protein loss is increased

 

Increased

Decreased

Lifestyle behavior change

Sitting time

Screen time

Stress/anxiety

Meal frequency

Snacking

Ultra-processed foods

Physical activity

Step count

Sleep quality

Protein intake

Sun exposure

Mechanisms of muscle loss

Cortisol

Oxidative stress,

Proinflammatory cytokines

Muscle protein breakdown

Vitamin D

Insulin sensitivity

mTORc1

Anabolic hormones

Muscle protein synthesis

Acute body compositions change

Chronic calorie

Adipose tissue accumulation

Skeletal mass

Muscle mass function

Long Term health risks

Cardiovascular disease

Diabetes

Osteoporosis

Cognitive decline

Depression

Physical frailty

Risk of COVID-19

Quality of life

    

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80

 

A summary of dietary intake, supplementation, and physical activities which can help to prevent the loss of muscle mass:

Daily physical activity

Dietary intake

Supplementation

Resistance exercise

Household chores

Walking at home

High-quality protein

25-40 grams protein per meal

Intake of whole and unprocessed food

Avoid intake of processed foods and snacks

Leucine 2.5 grams with lower protein meals

Creatine 5 grams daily

Fish oil 4 grams daily

Vitamin D3- 1000-4000 IU daily

 

 

Measures to Prevent Weight Loss and Cachexia in COVID-19 

 

COVID-19 disease can cause considerable weight loss and clinical cachexia in patients. There are reports of 589 patients of covid-19 showing weight loss and clinical cachexia. The severity of the disease and the timing of assessment were variable for different patients. 11% of the patients (65 patients) were treated in intensive care units at the time of assessment and 31% of patients (183 patients) cared in intermediate care structures. The frequency of weight loss ≥5% (that defines cachexia) was 37% (range 29-52%). Weight loss occurs in correspondence with raised levels of C-reactive protein, impaired renal function, and longer morbidity due to COVID-19. 


According to seven studies on 6661 patients, only 4% of patients were found underweight (BMI < 18.5 kg/m2 ). 


Cachexia is commonly observed in association with many chronic diseases. COVID-19 associated cachexia is understood to affect muscle and fat tissue.  Major factors which contribute to muscle wasting in COVID-19, include loss of appetite and taste, fever and inflammation, immobilization, as well as general malnutrition, catabolic-anabolic imbalance, endocrine dysfunction. Additionally, organ-specific complications of COVID-19 disease such as cardiac and renal dysfunction also cause muscle wasting. Overall, treatment of COVID-19 patients should focus on nutritional support and rehabilitative exercise in addition to medicines. There is no specific treatment for cachexia associated with COVID-19, so, a high medical intervention is needed to prevent long-term disability due to acute COVID-19 disease.

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80


Importance of Vitamin D Supplementation during COVID-19

 

COVID-19 is a disease caused by a highly infectious virus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The disease is characterized by mild-to-severe clinical symptoms such as flu-like symptoms, fever, headache, dry cough, muscle pain, loss of smell and taste, increased shortness of breath, bilateral viral pneumonia, conjunctivitis, acute respiratory distress syndromes, respiratory failure, cytokine release syndrome (CRS), sepsis, etc. Till May 18, 2020, there have been more than 4.7 million cases and over 316,000 deaths worldwide. 


The treatment for infection with this novel coronavirus is yet to be discovered by doctors and scientists. Two main questions should be addressed urgently: 


1.  How to prevent the infection in people with suppressed immunity and  
2. How to treat severe symptoms of COVID-19, including CRS, acute respiratory failure, and the loss of somatosensation.


Previous experience of the 1918 influenza pandemic has suggested that vitamin D may play an important role in reducing lethal pneumonia and fatality rates. According to reports provided by some recent clinical trials, supplementation of vitamin D can reduce the incidence of acute respiratory infection and can also reduce the severity of respiratory tract diseases in adults and children. 


There are no articles on clinical trials till July 1st, 2020, for showing the relation between vitamin D supplementation and prevention and treatment for COVID-19.

 

Let’s summarize the potential role of vitamin D

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80

 

The focus should be on three major topics: 


1. Vitamin D might aid in preventing SARS-CoV-2 infection: 
2. Vitamin D might act as a strong immunosuppressant inhibiting cytokine release syndrome in COVID-19
3. Vitamin D might prevent loss of neural sensation in COVID-19 by stimulating the expression of neurotrophins like Nerve Growth Factor (NGF)

 

 

Effect of Quarantine on Older Adults:

 

Older adults are the most vulnerable population affected by the pandemic COVID-19. An efficient treatment for COVID-19 is not ready yet. Since there is no specific treatment and the virus is very much contagious, a general quarantine has been initiated as a preventive action against the spread of the disease. This intervention on the one hand is protecting against the disease but is reducing the physical activity level on the other hand. 

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80


There are several negative health effects of sedentariness, especially on older adults, including increased risk of fall, fractures, and disabilities. Most of the studies have reported that implementation of physical exercise (such as walking, low load resistance, or in-bed exercise) during periods of disuse to protect muscle mass and function from the catabolic crisis is beneficial. Overall, physical rehabilitation, in addition to intense resistance training, and proper nutrition is necessary to prevent loss of skeletal muscles and also to regain the lost muscles for older adults.

 

Impact of Sedentarism on Neuromuscular, Cardiovascular, and Metabolic Health

 

The COVID-19 pandemic has led the entire population to self-isolate and live-in home confinement for several weeks to months. This in itself gave rise to several significant health risks. Several studies have reported that muscle wasting occurs rapidly, being detectable within two days of inactivity. This muscle mass loss is linked with fiber denervation, neuromuscular junction damage, and upregulation of protein breakdown.  It is mostly due to the suppression of muscle protein synthesis. Sedentarism also has adverse effects on glucose homeostasis. Just a few days of bed rest can lead to reduced insulin sensitivity. The aerobic capacity of the body is also impaired at all levels, from the cardiovascular system including peripheral circulation to the oxidative functions of the skeletal muscles. 


Physical inactivity results in positive energy balance which in turn increases fat deposition. Fat deposition leads to systemic inflammation and activation of antioxidant defenses, exacerbating muscle loss. The adverse effects of inactivity can be overlapped by routine exercise practice, but the exercise dose-response relationship is currently unknown. A reduction in 15-25% of calorie intake combined with low to medium-intensity home-based resistive exercises will have positive effects on health. This combination is ideal for preserving neuromuscular, metabolic, and cardiovascular health.

 

COVID-19  and Tinnitus

 

Most people who get infected by coronavirus suffer from mild to moderate symptoms, including respiratory symptoms, neurological symptoms, central nervous system manifestations, peripheral nervous manifestations, and skeletal muscle manifestations. The negative effect of coronavirus on the hearing organs including the inner ear is a new finding and yet to be explored. Currently, there is little evidence published connecting novel coronavirus and tinnitus directly. According to the findings of the American Tinnitus Association, pre-existing behavioral conditions like stress and depression associated with social isolation and infection avoidance increase the risk of tinnitus in patients.

 

Nutritional Management of Patient with COVID-19 Infection

 

The respiratory complications associated with COVID-19 are the major cause of morbidity and mortality for the same. Those are most vulnerable whose immune system is compromised, including older adults, polymorbid people, and malnourished people. 


Nutritional management for people at high risk of COVID-19 infection, people suffering from COVID-19, and COVID-19 ICU patients requiring ventilation:

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80

 

Nutritional management for people at high risk of COVID-19 infection, people suffering from COVID-19, and COVID-19 ICU patients requiring ventilation:

People at high risk for developing COVID-19

COVID-19 ICU patients

1. Check for malnutrition: Check using MUST criteria or for hospitalized patients, the NRS 2002 criteria.

1. Check for malnutrition: Check using MUST criteria or for hospitalized patients, the NRS 2002 criteria.

2. Optimization of nutritional criteria: People with malnutrition should undergo diet counseling from an experienced professional.

2. Nutrition in non-intubated ICU patients: When the target is not achieved by oral nutrition, start ONS, followed by EN. If still the nutritional goals are not fulfilled then start PN.

3. Supplementation with vitamins and minerals: People with malnutrition should be ensured for the supplementation of vitamin A, vitamin D, and other micronutrients.

3. Nutrition in intubated patients 1: Start tube feeding through a nasogastric tube, when there is gastric intolerance or high risk of aspiration, start postpyloric feeding.

4. Regular physical activity: Quarantine people must do physical activities while taking precautions.

4. Nutrition in intubated patients 2: When the full dose of EN is not tolerated in the first week, start PN

5. Oral nutrition supplements (ONS): When dietary intake and supplementation are not enough to reach nutritional goals, use ONS whenever possible.

5. Nutrition in ICU patients with dysphagia: Texture-adapted food can be administered after extubation. If swallowing is unsafe, EN can be initiated.

6. Enteral nutrition: When nutritional goals are not fulfilled orally, try enteral nutrition, and when enteral nutrition is not enough, try parenteral nutrition.

 

 


COVID-19 Infection and Neurological Dysfunction

 

COVID-19 is linked to several neurological disorders. Most of the people suffering from COVID-19 respiratory disease experience headache, nausea, and vomiting, and up to 40% present also experience dizziness, confusion, cerebrovascular disease, muscle pain, ataxia, and seizures. Defects in visual acuity, loss of smell and taste sensation, and pain are also associated with COVID-19 infection. Such central nervous system (CNS) signs and symptoms linked with COVID-19 infection may be life-threatening. Health care providers currently evaluating patients with neurological symptoms need to consider COVID-19 in any differential diagnosis. This will facilitate testing, isolation, and prevention of the spread of the virus. 


Neurological signs and symptoms associated with COVID-19:

 

  1. Neuroinflammation 

  2. Delirium and cognitive impairments

  3. Loss of smell and taste

  4. Cardiac dysfunction

  5. Acute respiratory distress syndrome (ARDS)

  6. The brain stem (Cardiac and respiratory dysfunction)

  7. Spinal cord injuries

  8. Stroke

  9. Muscle pain and fatigue

 


ICU Acquired Weakness

 

The basic reason for the ICU acquired weakness is the critical illness itself and results in sustained disability long after the ICU stay. This weakness can result in muscle wasting, impaired contractility, neuropathy, and major pathways associated with muscle protein degradation such as the ubiquitin-proteasome system and dysregulated autophagy. 


Most of the risk factors associated with ICU acquired weakness has been identified, there is a need for effective interventions to offset these changes remain elusive. 


Let’s discuss the various proposed pathways involved in the pathophysiology of ICUAW. Also, we will discuss the contribution of inflammation, steroid use, and paralysis to the development of ICUAW and how it pertains to those with the coronavirus disease of 2019 (COVID-19).


Then intervention needed to avoid and overcome these critical illnesses will be discussed. 
 

Changes monitored inpatient with definite critical illness myopathy (CIM):

 

  1. Severe muscle atrophy, affecting both type 1 and type 2 fibers. 

  2. Significant loss of thick filament protein myosin.

  3. Eventual sarcomere disorganization.

  4. Electrical hypoexcitability of the muscle and poor excitation-contraction coupling. 

 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80

 

Summary of known molecular mediators of muscle wasting in critical illness:

Within ICU

Post ICU

Muscle degradation

Impaired muscle repair

Proteolysis > protein synthesis

Proteolysis _  protein synthesis

Treatment promoting muscle protein synthesis in ICU

Treatment promoting muscle repair post ICU

Early mobilization

Blood flow restricted exercise?

In-bed cycle ergometry

Targeting AMP-activated protein kinase?

Neuromuscular Electrical Stimulation

Intramuscular injection of mesenchymal stem cells?

Nutrition supplementation

 

Hormone therapy

 

 


Resistance Training During and After COVID-19 Disease

 

The adverse consequences of isolation are the absence of organized training and competition, lack of communication among athletes and coaches, inability to move freely, lack of adequate sunlight exposure, and inappropriate training conditions. The mobility restriction to stop the spread of the COVID-19 virus led to negative effects on physical conditions, including muscle atrophy, progressive loss of muscle strength, and reductions in neuromuscular and mechanical capacities. Resistance training (RT) might be an effective tool to counteract these adverse consequences. Due to its numerous health benefits, RT is considered an essential part of an exercise program. RT can be adapted to allow its performance with measures adopted to control coronavirus outbreaks such that the benefits would largely overcome the potential risks.
 

Post-COVID - 19 Recovery Diet

80% OFF, Use coupon COVID19_80