Can diet help post-viral fatigue?

What you eat after a viral infection, when symptoms of fatigue persist, can have a marked impact on your speed of recovery. Some authors claim that to improve fatigue specific foods need to be totally avoided, or included in your diet. So what is the truth and the evidence about diet and post-viral fatigue?

The COVID-19 virus is a new illness and behaves in different ways to other viruses. It is unclear whether the ongoing symptoms such as fatigue differ from other viral illnesses. Doctors and scientists are still trying to understand more the mechanisms causing the symptoms and effective treatments. To date, there is no research, or evidence, that any one diet or vitamin supplement is beneficial, for post-viral fatigue. The only exception is vitamin D where internationally experts recognise that it is possible that those who are vitamin D deficient could be at increased risk of contracting COVID-19 or for having a more severe disease course. However, at this point, further research is ongoing to determine if taking vitamin D supplements is beneficial.  In the UK it is recommended for everyone to have a 10 micrograms (400iu) supplement daily as vitamin D does play a key role in the body’s immune function.  Be very cautious of other claims advising on a restrictive diet, cutting out basic foods or recommending expensive supplements.

The following questions are worth asking in the order of importance for fatigue symptoms:

Have I lost unwanted weight, 5-10%, in the last 3-6 months?

Some planned weight loss, when you are eating a good varied range of food, can be beneficial to your health.  However, often when you are unwell and feeling fatigued your appetite and intake may not be good. This unplanned weight loss will put you at risk of malnutrition, reducing your muscle protein, immune system effectiveness, and your recovery. There are some excellent online resources to check if you, or someone you are concerned about, may be at risk of malnutrition, with tips to help.

Am I drinking enough fluids?

Not hydrating enough can add to fatigue, headache, and dizziness, but this does not mean necessarily drinking lots more water. If you have suffered a prolonged period of poor eating, drinking nourishing fluids will give added nutrition value as well as help your fluid intake.  These can be a good way of regaining any unwanted weight loss. Nourishing fluids can be milk (animal or plant variety), or fruit juice bases with added fruit (fresh or frozen), dried milk powder, ice-cream, cream or flavourings to boost calorie and protein intake.

Am I eating well enough?

Having post-viral fatigue means that you will not have your usual energy to think, shop, prepare or eat as before.  Be very practical and kind on yourself. Eating a readymade meal is far better nutritionally than skipping or instead eating processed high sugar/fat snacks, such as biscuits, cake, pie, chocolate, or too many takeaways. Enlist help, plan, batch cook, and freeze.  Be realistic about how much you are able to prepare and cook yourself and use more from the freezer. Even tinned beans, fruit or veg may be useful, as well as dried foods as well as dried foods to supplement fresh foods. For healthier snacks try nuts, seeds, and dried fruit.

The key to eating well is

  1. More plant-based foods - vegetables, fruit, nut, seeds, beans, pulses and wholegrains. Eat a variety of colour each day, as there is growing evidence that this will help the trillions of bacteria in your gut or microbiome, which in turn helps your immune system and overall well-being.  There is no one special, or ‘magic’, food to eat - the key is diversity and balance.

  2. Regular meals and include snacks - ‘little and often’ may work best.

  3. Include some wholegrain carbs that release their glucose or energy slowly. This will increase your fibre intake for good gut health and potentially help your energy levels as well. Low Glycaemic Index or slow-release carbs include oats, beans, pulses, pasta, wholegrains and milk.

  4. Enjoy treats now and again, but avoid eating too much as this could stop you eating healthier things.So, in summary, diet can aid your recovery from post-viral fatigue, especially if you have lost unwanted weight and are unable to eat well for some time.  Healthy foods will always give you added nutrition value over individual vitamin supplements, but when fatigued you will need to be very practical.

 Written by Sue Luscombe, Specialist Dietitian

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Long-COVID- an Update from Dr G Coakley

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How to use exercise therapeutically when you have Post-Viral Fatigue Syndrome (PVFS)