Coronavirus

What information can I share with my patients about nutrition during COVID-19?

Lauren Ball   
doi: 10.31128/AJGP-COVID-17   |    Download article
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The current COVID-19 pandemic is causing unprecedented strain on general practice and will likely be the greatest communicable healthcare challenge of our lives. However, general practice does not normally experience this type of pressure of communicable disease. Non-communicable diseases such as type 2 diabetes, cardiovascular disease and other chronic conditions cause the largest burden on Australian healthcare and have therefore required the most attention in general practice to date.1 Nutrition is well recognised as a central component of a healthy lifestyle.2 Over the past 50 years, diets low in fruit and vegetables and high in salt and fats have contributed to a significant and increasing prevalence of chronic disease.3 Unsurprisingly, the role and relevance of nutrition is being debated among health providers and community members.

Diet and COVID-19

On 20 March 2020, the Director-General of the World Health Organization (WHO) emphasised the importance of good nutrition to protect the immune system.4 The WHO has released advice for maintaining food security during periods of isolation5 and recommended that mothers who are breastfeeding continue to do so.6 The underlying rationale is that good nutrition is crucial for good health, particularly at times when the immune system may be working hard. These recommendations are evidence based and should be incorporated into practice for patients wanting support.

Alarmingly, anecdotes and misinformation about nutrition and COVID-19 have flooded social media, risking patient safety and high-quality healthcare. Celebrity chefs have been accused of using COVID-19 for financial gain.7 Intravenous vitamin ‘infusions’, high-dose micronutrient supplementation (iron and vitamin D) and high-protein dietary products have been promoted at a cost to consumers as a means to reduce the likelihood and severity of infection. It is vital that general practitioners (GPs) can assist patients to critically evaluate these claims before passing on any recommendation to patients. Nutritional advice should be evidence based and from a reputable source such as a state or federal health service, peer-reviewed reputable journal or university. It is worth noting that vitamins and food components are not part of the latest evidence on non-pharmaceutical interventions to reduce COVID-19 mortality.8 Such advice should therefore not be part of healthcare practice.

Everybody eats

Most Australians will not contract COVID-19. However, many GPs in low-socioeconomic areas will be intimately aware of the difficulties associated with food insecurity. Many Australians risk poor health while social distancing as a result of food insecurity, especially vulnerable populations such as older Australians, individuals with disability, and migrant and refugee families. However, attention is also needed for groups who might now be affected who were not before, such as those who have lost employment. Some states and territories have nutrition resources for residents including food storage tips and simple recipes.9,10 Internationally, the NNEdPro Global Centre for Nutrition and Health has produced a rapid review and 10-point summary on nutrition and COVID-19.11

Nutrition care should be sustained

Australians highly value discussions about nutrition during consultations with health providers.12 They want to be asked questions about their diet and appreciate when they are referred to nutrition specialists such as dietitians.13 Supporting patients to receive support (via telehealth) from accredited practising dietitians14 can be an effective way to ensure that patients are eating well to manage their health during this time. In the wake of the current COVID-19 pandemic, nutrition care that focuses on food security is imperative. Healthy eating for preventing and managing chronic disease should also not be forgotten.

Resources

First published online 29 April 2020.

Competing interests: LB reports investigator grants from National Health and Medical Research Council.
Provenance and peer review: Commissioned, peer reviewed.
Citation: Ball L. What information can I share with my patients about nutrition during COVID-19? Aust J Gen Pract 2020;49 Suppl 17. doi: 10.31128/AJGP-COVID-17. [ePub ahead of print]

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