Question: I have had gut problems and then caught Covid-19, which caused loss of taste, smell and weight, not helped by feelings of nausea. A gastroenterologist’s advice to change to a low-Fodmap diet has helped considerably with the gut problems. But I am often left feeling hungry and sometimes craving sweet foods. Taste and smell have not yet returned, so food doesn’t hold any great attraction other than it is necessary. Any guidance would be appreciated as it seems I am not alone, especially with the after-effects of Covid.
Answer: Covid-19 infections can cause significant fatigue, loss of taste and smell, reduced appetite, and breathing difficulties, leading to less desire to eat and potentially unexpected weight loss. Given the accumulating evidence that suggests eating a nutritious diet during and after the active Covid-19 infection speeds up recovery, how are we supposed to juggle our body’s nutritional needs with a lacklustre appetite?
The effect of the virus on food intake can be significant. A French study published last year, NutriCoviD30, found Covid patients admitted to hospital decreased their food intake by about 70% during the active phase of illness, resulting in an average loss of 8% of their pre-virus weight. And although most patients soon recovered their appetite after hospital discharge, 41% still met the criteria for malnutrition one month after release.
Given that nutritional status significantly affects our immune system’s response to infections, we must do all we can to boost our wellbeing during and in recovery from a virus. Indeed, an observational study published in 2021 in the International Journal of Environmental Research and Public Health associated a healthier diet with faster recovery among non-hospitalised Covid-19 patients.
And a study published this year in JAMA Internal Medicine reported that those who had a healthy lifestyle before infection were less likely to develop long Covid. The lifestyle factors assessed were BMI, smoking status, alcohol consumption, diet, physical activity and sleep.
An earlier study, published in 2022 in Clinical Nutrition, backs these findings. In particular, higher alcohol intakes appeared to have a negative effect on recovery from Covid-19, whereas eating nutritious foods rich in healthy fats, protein, antioxidants and micronutrients such as selenium and zinc was associated with improved recovery. Specific foods that appeared to benefit recovery were eggs, fish and seafood, fruits, vegetables (including starchy root vegetables), meat, milk, nuts and vegetable oils.
In yet another study, published in the European Journal of Clinical Nutrition last year, Iranian researchers found moderate intake of low-fat dairy products was associated with a reduced risk of Covid-19 infection, and appeared to have a protective role.
Of course, eating nutritious food during an infection and recovery can be physically challenging. Therefore, focus – particularly initially – on maintaining a diet high in protein and energy, so your body gets the nourishment it needs to prevent muscle and weight loss and optimise your immunity. Also, keep well hydrated by drinking plenty of fluids: choose milk-based drinks to get more nutrients.
Typically, our enjoyment of food comes from its different flavours. However, a study published in 2021 in the journal Foods noted that during a Covid-19 infection, food enjoyment without a good sense of smell and taste could be improved by focusing on food texture and the benefits of choosing nutritious foods.
Beating Covid
Try these tips when you have a reduced appetite from Covid-19:
- Eat little meals or snacks frequently: try to eat something every 1-2 hours; aim for three small meals and three snacks a day.
- Eat your largest meal at a time when your appetite is best: for instance, if you’re hungrier in the mornings, have a bigger breakfast than usual.
- Allow sufficient time for eating: you may need to eat more slowly, so give yourself plenty of time to eat at a slower pace.
- Eat familiar foods that are nourishing. While your senses of taste and smell are lacking, it is often better to choose familiar, nourishing foods to provide comfort.
- Choose convenient foods. Now is not the time to burden yourself with complicated meals that require extensive preparation; choose easy-to-prepare or ready-to-eat meals.
- Try to do some gentle physical activity before eating, as this may help to boost your appetite.
Sources: Health Service Executive Ireland and Høier et al, Foods journal, 2021.
