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Nutrition and Diet-Blending Traditional Indian and Mediterranean Principles: For Persons with Mild, Asymptomatic or Recovering from COVID-19

This document provides information on nutrition and diet that can help your body and mind heal as you recover from COVID-19 or self-isolate at home. The document does not intend to replace special nutritional requirements that are advised by doctors and do not replace medical advice. People with additional illnesses must follow the diet plans that are prescribed for them. People with any allergies are advised caution and due diligence before consuming any food.

COVID-19 has a large range of symptoms. One distressing symptom is the lack of taste or smell that affects people with COVID-19. The loss of taste and smell also lead to a loss of appetite as the sensory aspects of food get affected. The loss of appetite and reduced intake of food is a problem in post disease states as it can lead to reduced immunity and prolonged recovery times as the body takes more time to heal.


The diet and nutrition plans include traditional nutrients that are available in different parts of India. These diet plans aim to help the body heal itself in a healthy way and may not impact or treat Coronavirus.

It is also important to consider that each person will need a specific nutrition plan that addresses the body constitution and needs of the person. In this document, we provide some diet plans that can be taken by most people. However, we recommend that you follow any specific diet plans that have been prescribed by your doctors.


Consider these as comfort foods that can help you walk back to normal after a Coronavirus infection. The diet plan in this program is based on blending scientific principles that underlie the traditional Indian and Mediterranean diet.

Beverages

Hydration is an important part of the recovery process. The body needs adequate hydration to heal itself.


Warm Water
Warm water is the best drink. You can boil the water with common herbs like Tulsi, Mint, and spices like Jeera, cardamom, Ajwain. Consume as early as possible if you have added any herbs. Warm water with a couple of drops of honey is good in the morning to soothe the throat.

Turmeric Milk
Ingredients
• ½ teaspoon turmeric
• ½ teaspoon ground peppercorns
• I cup Milk
• ¼ cup Water
Mix all ingredients and bring to boil. Continue to cook on medium heat, stirring continuously, till the water reduces and you are left with 1 cup of liquid. Peppercorns improve the absorption and availability of turmeric in the Body. Studies have shown a significant improvement in the absorption and bioavailability of turmeric (>100%) when pepper is added simultaneously.

Herbal Tea
Ingredients
• 3-4 cloves
• A pinch of ground nutmeg
• 2 pinches of ground cinnamon
• 2 pinches of ground cardamom
• ½ inch piece of crushed fresh ginger
• 1 teaspoon of black tea (can avoid also)
• 1 cup milk (can avoid)
• Sweetener of your choice
• I cup water
Boil the water and spices for 2 minutes. Add the tea and simmer for 2 minutes. Add milk and heat without boiling. Add sweetener as needed. Can avoid tea, milk, and sweetener.

Buttermilk or Lassi
Drink freshly prepared buttermilk or lassi. Add a very little salt or sugar if you prefer salt or sugar with these. You can add freshly crushed ginger, cardamon, cumin powder and mint if you prefer. You can have a glass after your meals.

Tender Coconut Water
Drink fresh tender coconut water. It is preferable not to drink stored coconut water. Drink as soon as possible after the coconut is cut. Tender coconut water is a sterile drink that is a good replacement for electrolytes.

Fresh Fruit and Vegetable Juices
Consume fresh fruit juices as a standalone drink. It is better not to mix it with other fruit items. Do NOT add sugar to the fruit juices. They are already sweet from the natural sugars in fruits.

It is preferable to eat fruit than to drink its juice as the fruit has got fibre.
Consume fresh vegetable juices as a standalone drink. Although several combinations f fruit and vegetable drinks are used, try to drink the juice of one vegetable at a time without mixing too many things. Beetroot, Spinach, Carrot, Green leafy juices are useful.

Do NOT add sugar. A pinch of salt and pepper may be added if needed.

Avoid Cold/Frozen Beverages. Choose Warm or Hot beverages instead.
Reduce/Avoid the use of sugar and salt. If you really want it, add as little as possible. Fruits and vegetables have natural sweeteners and salts.
Avoid any processed, aerated, fizzy or stored drink.
Keep yourself hydrated.

SOUPS


Soups are comfort drinks that are extremely useful to hydrate and heal your body. Soups also help to improve your appetite in a gentle way and can ease your way back into eating a meal.


Use a pinch of salt and a pinch of pepper with the soup if you prefer to. Thinly sliced ginger, garlic and mint and other herbs can also be used with the soup,

Use Freshly prepared warm soups than soups that are prepared from processed material or processed soups. Minimize the use of artificial thickeners like corn starch. You can consider the use of besan or chickpea flour to thicken the soup a bit.


Soups made of beans, peas and lentils and vegetables can provide a good protein and vitamin supplement in a natural way.

Lentil Soups
• Green Dal or Moong Dal Soup
• Urad Dal Soup
• Red Lentil (Masoor Dal) Soup
• Tur/Arhar/Sambhar Dal soup

Vegetable Soups
• Carrot Soup
• Green Peas Soup
• Beetroot Soup- Good to reduce blood pressure and improve blood circulation.
• Spinach Soup- Good to reduce blood pressure and improve blood circulation.
• Green beans soup
• Mixed Vegetable soups (Locally available, seasonal Vegetables)

Breakfast Foods


Break the fast gently. Light yet filling food items that are rich in proteins, minerals, vitamins and carbohydrates or which provide balanced nutrition is preferred. Choose foods that are culturally common in your area. Fermented food items are good to soothe and heal the gut.


• Idlis combined with Sambhar or different chutneys (Coconut, Sesame, peanut, Tomato)
o Traditional idlis
o Millet idlis
o Ragi idlis
o Beetroot idlis
o Spinach idlis

• Fermented batter dosas
o Rava Dosa
o Appam

• Dhoklas
• Upma
• Khichdi (especially moong dal khichdi)
• Pongal
• Rotis
• Steamed food items
• Sabudana (Sago) Khichdi or Upma
• Poha
• Sprouts
• Rice gruel with moong dal
• Fermented Curd rice with moong dal
• Ragi with Buttermilk and a pinch of salt


These can be coupled with coconut, sesame, peanut or tomato or green leafy chutneys or with curries that are based on lentils and vegetables.

Use as little salt as needed for the preparations. Eat freshly prepared food. Avoid processed foods or ready to eat frozen or packaged food. Avoid deep-fried oily food.

Have a glass of herbal tea half an hour before breakfast or half an hour after breakfast.

Lunch Foods


Choose light, filling and freshly prepared foods. Steamed, Boiled or foods that use minimal oil are preferred.


Choose items based on the cultural traditions of the area. Rice, Rotis, Lentils, locally available seasonal Vegetables, sprouts, Yoghurt. You can replace Rice and Rotis with Ragi Sanghadi or Ragi Balls or other millet or whole-grain preparations.

Avoid pickles and similar highly salted, spicy foods. Reduce or avoid sugary desserts.

You can have soup half an hour before lunch. You can have buttermilk or Lassi after lunch.

Eat in moderation.

Dinner


Eat an early dinner preferably between 6 pm and 7 pm or latest by 730 pm.
Choose light, filling and freshly prepared food.


Steamed or boiled vegetables, diced vegetables and roasted unsalted nuts, green leafy vegetables with a small portion of lentils, rice and/or roti, yogurt or curd.


You can have a cup of warm soup half an hour before dinner. Have a glass of buttermilk after Dinner.


Fruits


Eat Seasonal Fruits
Eat fruits in isolation and do not mix with other meals or drinks. It is better to have the fruits in between meals as a snack. A serving of fruit 2 to 3 times a day is useful. Choose your fruits carefully if you have diabetes.
Choose only locally available and seasonal fruits.
Do not add any sugar or other seasoning to the fruits.
Fruits like Guava, Bananas, Pineapple, Watermelon and other melons, Mangoes are useful. Every fruit has its own benefits. Choose seasonal local fruits for the best benefits.

Things to Remember


• Reduce or avoid the use of sugar and artificial sweeteners.
• Reduce or avoid the use of salt.-
• Reduce the “Chilli” factor of your food.
• Try to get the natural flavour of the vegetables and fruits you eat. Always choose seasonal, locally available foods.
• Green leafy vegetables are especially useful. Moringa leaves are a rich source of nutrients. Add more dark green leafy vegetables to the diet. Do not boil or overcook green leafy vegetables,
• Lentils, Sprouts and Legumes are good. You can alternate between them throughout the week.
• Eat less meat if you are a meat-eater. Fish and eggs may be a better source of protein and helpful in recovery.
• Add a small dash of ghee to your meals.
• Fruits and Vegetables have many natural healing properties. Eat a serving of fruit three times a day.
• Do not drink sugary, aerated, and cold drinks.
• Take a fistful of nuts every day. You can take dry fruits if you can.
• Reduce the use of oil. You need not completely avoid oil but reduce the quantity of oil used for cooking.
• Consider the foods that are eaten during festivals before a fast or after a fast. These are usually light, and highly nutritious.
• AVOID any processed food, frozen food or stored food.
• KEEP YOUR DIABETES UNDER CONTROL
• KEEP BLOOD PRESSURE UNDER CONTROL.

Select References

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  2. Lad U, Lad V. Ayurvedic Cooking for self healing. 2010.
  3. Palaiodimos L, Kokkinidis DG, Li W, Karamanis D, Ognibene J, Arora S, et al. Severe obesity, increasing age and male sex are independently associated with worse in-hospital outcomes, and higher in-hospital mortality, in a cohort of patients with COVID-19 in the Bronx, New York. Metabolism. 2020;108:154262. https://doi.org/10.1016/j.metabol.2020.154262.
  4. Angelidi AM, Belanger MJ, Mantzoros CS. Commentary: COVID-19 and diabetes mellitus: what we know, how our patients should be treated now, and what should happen next. Metabolism. 2020;107:154245. https://doi.org/10.1016/j.metabol. 2020.154245.
  5. de Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FFZ, Prado CMM, Laviano A, Mota JF. Dietary recommendations during the COVID-19 pandemic [published on-line ahead of print, 2020 Jul 12]. Nutr Rev. 2020:nuaa067. https://doi.org/10.1093/nutrit/nuaa067.
  6. Kang I, Buckner T, Shay NF, Gu L, Chung S. Improvements in metabolic health with consumption of ellagic acid and subsequent conversion into urolithins: evidence and mechanisms. Adv Nutr. 2016;7(5):961–72 Published 2016 Sep 15 https://doi.org/10.3945/an.116.012575.
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  7. Andriantsitohaina R, Auger C, Chataigneau T, Étienne-Selloum N, Li H, Martínez MC, et al. Molecular mechanisms of the cardiovascular protective effects of polyphenols. Br J Nutr. 2012;108(9):1532–49. https://doi.org/10.1017/S0007114512003406.
  8. Alasalvar C, Salas-Salvadó J, Ros E. Bioactives and health benefits of nuts and dried fruits. Food Chem. 2020;314:126192.
  9. Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020; 18(1):229 Published 2020 Jun 8 https://doi.org/10.1186/s12967-020-02399-5.
  10. Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 out-break confinsement in the Spanish COVIDiet Study. Nutrients. 2020;12(6):1730. Published 2020 Jun 10 https://doi.org/10.3390/nu12061730.

Dr Praveen Nirmalan

Written by Dr Praveen Nirmalan

Dr. Nirmalan did his basic medical education from Thrissur, Kerala and followed it with a PG Diploma in Ophthalmology from Aravind Eye Care System, Madurai and a Vitreo-retinal Fellowship from Mumbai. Subsequently, he completed his MPH and a Public Health Ophthalmology Fellowship from the Johns Hopkins School of Public Health in the USA. He has led community-based and clinical research in some of the top eye care institutes of India and led a clinical research program at a top tier obstetric and neonate institute as well. He has experience chairing Ethics Committees and has helped with the setting up of Institutional Review Boards. Besides mentoring clinical faculty, he has mentored DNB and PhD students through their dissertation work and research methods.

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