Dietary Recommendations for Post-COVID-19 Syndrome, 2022, Barrea et al.

Abstract

At the beginning of the coronavirus disease (COVID-19) pandemic, global efforts focused on containing the spread of the virus and avoiding contagion. Currently, it is evident that health professionals should deal with the overall health status of COVID-19 survivors. Indeed, novel findings have identified post-COVID-19 syndrome, which is characterized by malnutrition, loss of fat-free mass, and low-grade inflammation.
In addition, the recovery might be complicated by persistent functional impairment (i.e., fatigue and muscle weakness, dysphagia, appetite loss, and taste/smell alterations) as well as psychological distress. Therefore, the appropriate evaluation of nutritional status (assessment of dietary intake, anthropometrics, and body composition) is one of the pillars in the management of these patients.
On the other hand, personalized dietary recommendations represent the best strategy to ensure recovery. Therefore, this review aimed to collect available evidence on the role of nutrients and their supplementation in post-COVID-19 syndrome to provide a practical guideline to nutritionists to tailor dietary interventions for patients recovering from COVID-19 infections.

Post-Covid Fatigue Syndrome:

Recent studies showed that a significant proportion of COVID-19 patients suffer from prolonged post-COVID-19 fatigue syndrome, with symptoms resembling chronic fatigue syndrome (CFS). The pathophysiology is complex and involves autonomic dysfunction, endocrine disturbances, and reactive mood disorders (i.e., depression or anxiety), combined with genetic, environmental, and socio-economic predispositions. At present, there is insufficient high-level evidence to directly support the use of nutritional supplements and modified diets to relieve symptoms in patients with post-COVID fatigue syndrome.
However, there is evidence to support that the deficiency of some nutrients (i.e., vitamin C, vitamin B group, sodium, magnesium, zinc, folic acid, l-carnitine, l-tryptophan, essential fatty acids, and coenzyme Q10) seems to be important in the severity and progression of CFS symptoms by increasing oxidative stress.

Recently, several trials focusing on CFS patients have reported the benefit of antioxidants and lipids to reduce CFS symptoms. Indeed, the supplementation of glycophospholipid–antioxidant–vitamin demonstrated an improvement in the overall fatigue scores of moderate subjects measured using the Piper Fatigue Scale (PFS).
Therefore, adequate nutritional supplements including essential fatty acids and antioxidants, or the same given in the form of a balanced healthy diet, could help in the control/alleviation of post-COVID-19 fatigue syndrome.


https://www.mdpi.com/2072-6643/14/6/1305/htm

 

Though not mentioned in this abstract, are we seeing with Long Covid the development of higher rates of various food intolerances than in the well population or is it too soon for people to recognise any food intolerances in the course of their Long Covid?

It took me several years to recognise my gluten intolerance, as symptoms are delayed by 24 hours following ingestion and only once gluten was largely eliminated from my diet was it possible to see the pattern of symptoms resulting from when I did eat food containing gluten and to distinguish this from ME in general as there is a large symptom overlap. Also for me other intolerances such as caffeine only seemed to emerge as my ME worsened over a number of years.

It is frustrating that there is so little reliable evidence or good research in this field.

 

I ate very healthy before and during PVFS for 5-6 years. I never lost my appetite and was so positive that everyone in my family and friends didn't believe I was even ill. I also gained 7lbs which was a lot for me. My test results (antioxidants, proteins, fats et) were well below normal and that of malnourished person.

I replenished all my deficiencies and still have M.E.

 

Disappointing that they completely missed the most important: foods to avoid. By now I have read thousands of comments from long haulers. The only way I see food discussed, and it happens often, is in the context of some foods triggering symptoms and avoiding them. (Other than lack of appetite and anosmia leading to food not tasting anything)

It's not fully consistent between people so there's a lot of trial and error but there do seem to be certain types of food that commonly cause significant digestion problems or increase symptoms. And holy crap the only reference to one of the two main ones is advice to drink more coffee (to increase fluid intake). Major facepalm. The other is alcohol, of course.

Avoiding certain foods, and even more importantly identifying which cause problems is basically the only way this topic is discussed as being relevant and significant by pwLC. It's usually discussed as histamine-rich or "inflammatory" foods, which is probably incorrect but the general idea obviously is and would benefit from expert input.

But experts don't listen to patients and this study falls for the usual trap of being about what interests the researchers and the questions they think of, not what's happening to the patients. Once more, the experts are mostly shambling around in circles ignoring what the patient community has known for well over a year by now. This is not how expertise works, this is bordering on anti-expertise, where prior knowledge is actually an obstacle to learning from experience because it boxes in all thinking.

I'm really beginning to see a major problem with the usual top-down "here's a bunch of books, memorize all of it" method of teaching medicine and how it's the complete opposite mode of thinking that makes some people able to learn from experience much quicker than others. If the only way most physicians learn is through a class model with a teacher, a textbook and an answer key where answering wrong is clear and unambiguous, no wonder medical research is struggling so hard, this is the opposite of how learning from experience works, where everything is fuzzy and you have to listen to what patients are saying because they are literally the whole point of it all.