An elderly man eating dinner with his grandchildren
Eating Well
An elderly man eating dinner with his grandchildren

Many people experience loss of appetite and reduced food intake when unwell with COVID and during their recovery. It is normal to feel tired after being unwell, and recovery can take time.

You may find that you have difficulties with shopping, preparing food and difficulty eating your normal portion sizes. This may be because you feel tired or weak. You may have some new symptoms associated with COVID like smell and taste changes, shortness of breath dry mouth, nausea and constipation (see section below for more information on managing these).

This can make it difficult to get the right nutrition you need to help you do your day-to-day activities and could delay recovery.

 

Why is it important to eat well after being diagnosed with COVID?

Eating well is important as your body needs energy, protein, vitamins and minerals to help you recover. Having a good intake of protein and energy rich foods supports you with rebuilding muscles, maintaining your immune system and increasing your energy levels to allow you to do your usual activities.

 

I am underweight or I have lost a lot of weight or I am struggling to eat enough. What should I eat?

Minimising weight loss and regaining muscle strength is important for your recovery. It is important to monitor your weight and look out for signs of weight loss including your clothes and jewellery becoming loose.

You may find meals a bit overwhelming at the moment but you should try to eat little and often this may include three small nourishing meals plus nourishing snacks/drinks in between until your appetite picks up. Choose protein-rich (meat, fish, eggs, cheese, beans and lentils) and energy-rich foods. Serve food on small plates to make it more appealing.

Keep well hydrated by drinking plenty of fluids. Choose milk-based drinks as these provide additional nutrients like protein.

Ask you GP to refer you to a dietitian for further advice and support, and in the meantime, you may find the information below helpful.

Ideas for nourishing meals
Cottage cheese/beans with a small baked potato. Sandwich with meat, cheese or egg.
Fish/chicken curry with rice. Scrambled/poached egg on toast/bagel.
Prawn/chicken with noodles. Dhal with naan bread.
Stew made with meat or a meat alternative (Quorn or tofu) and dumplings. Egg omelette with potatoes.

 

Ideas for nourishing snacks
Greek yoghurt. Portion of nuts (30g).
Cheese, pâté or hummus on crackers. Custard/milky pudding and stewed fruit.
There are many foods that you can add to meals to increase the energy and protein content of your diet. You may wish to try using “enriched milk” which will provide you with extra protein. Add 4 tablespoons skimmed milk powder to one pint of whole milk. Use this pint of enriched milk throughout the day in drinks, cereals and or sauces.

 

Ideas for adding extra energy and protein into food
Peanut butter, cashew nut butter, almond butter – add to soup, curry and sauces. Plain yoghurt (choose ones marked ‘high in protein’) – can be eaten with breakfast cereal and fruit or added to soup, curry and stews.
Ground almonds – add to soup and sauces. Dried skimmed milk powder.
Gram (chickpea) flour Grated cheese – add to mash potato, scrambled egg and soup.

 

I’ve been prescribed nutrition drinks ‘oral nutritional supplements’; how I should take these?

  • Oral nutrition supplements provide you with extra energy and nutrition, such as protein. You should take these between meals so they don’t affect your appetite at meal times.
  • Ask your healthcare professional if you can try different flavours of drinks. It is important to find the right nutritional supplement for you as this will help you continue to take them. In some areas desserts and soups may also be available. Serving drinks/desserts either chilled or frozen may help you to take them.
  • Once opened you must keep them refrigerated, but only for as long as recommended on the product.
  • If you are struggling with breathlessness – your healthcare professional may be able to prescribe/request smaller bottles which may be easier to take.
  • If you are struggling with swallowing, speak to your healthcare professional – thickened supplements may be safer for you to take.

 

How long should I take oral nutritional supplements for?

Your need for oral nutritional supplements should be reviewed regularly by your GP/Dietitian. When to stop them will depend on your weight, symptoms and how much of your prescription you are able to take. If you are uncertain about how to take them, how long for, or how helpful they are, speak to your GP or Dietitian.

 

Should I be taking any vitamin or mineral supplements?

Multivitamin and mineral supplement – if you are only eating small amounts or are unable to eat all the recommended food groups then you may wish to consider taking a multivitamin and mineral supplement. If you have been advised to take an oral nutritional supplement drink, these will contain vitamins and minerals.

Vitamin D

If you are not well enough to spend time outside regularly, or if you are over 65, or have a darker skin tone, your body may not be able to make enough vitamin D. In these situations, take a daily Vitamin D supplement containing 10 micrograms daily. You can buy these from most supermarkets and pharmacies.

 

I’m not underweight but I have lost a small amount of weight or my appetite is not improving. What should I eat?

Check your weight regularly. If you are losing more weight or strength, speak to your GP, they may refer you to a Dietitian who can adjust advice to suit you.

Choose small nourishing meals and snacks to ensure you get enough energy and protein. It is likely that you have lost muscle mass during your illness. A good protein source during breakfast, lunch and evening can help you to recover your strength.

Follow the advice in:

 

I am not underweight and I haven’t lost any weight, what should I eat?

Eating a variety of healthy foods from the tables below will help you recover and regain strength.

Protein foods
Aim to have three palm-sized portions per day.
Meat, fish, eggs, beans, pulses, nuts, chickpeas and meat-alternatives e.g. Quorn or tofu. Keeps your immune system healthy and maintains your muscle strength.

 

Dairy/daily alternative foods
Aim for three thumb-sized portions per day.
Milk, food items including cheese and yoghurt, and milk alternatives such as soya milk fortified with calcium. Provides calcium which helps to keep your teeth and bones strong.

 

Fruit and vegetables
Aim for five portions per day.
One portion = 80g of fresh, frozen or tinned (fruit should be in own juice), one tablespoon of dried or a maximum of 150ml of fruit juice. Provide vitamins and minerals as well as fibre.

 

Starchy foods
Aim for a quarter of main meals to include starchy foods.
Rice, potato, cereals, noodles, chapattis, pasta and bread. Where possible, choose wholegrain varieties. Provide energy and fibre which helps keep your bowels regular.

 

Oils and spreads
Aim for unsaturated varieties such as, sunflower, olive or rapeseed-based oils or spreads Provide energy and helps us to absorb some vitamins

 

When planning a meal, it may be helpful to aim for half of your plate to include salad/vegetables, a quarter to include protein and the final quarter to include starchy carbohydrates.

 

I have taste/smell changes, shortness of breath, dry mouth or tiredness that affect what and how much I can eat, what can I do?

Not everyone will experience the following symptoms of COVID. If you do experience them, these tips may help. If this continues to be a problem, ask your GP to refer you to a dietitian for further advice and support.

Taste and smell changes

These are usually short-term but can still have a significant effect on your food intake. Refer to the section on changes to Taste and Smell.

Short of breath

  • Try to eat little and often.
  • Try to have drinks in-between meals instead of with your meals.
  • Soft and moist food can be easier to manage when you are tired or feeling breathless.

Dry mouth

  • Take regular sips of fluids throughout the day.
  • Add sauces to foods such as gravy, cheese/white sauce, mayonnaise, salad cream, yoghurt or dips.
  • Suck on sugar-free sweets or chew sugar free gum to help increase saliva production.

If your mouth is sore, contact your GP/pharmacist who may be able to request or prescribe medication to treat this.

Tiredness

  • Take your time at mealtimes.
  • Soft and moist food can be easier to manage when you are tired or feeling breathless.
  • Ready meals can be helpful if you are too tired to cook.

 

Constipation

You may experience constipation as a side effect to the medication you have been prescribed or due to being less active than normal.

  • Keep well hydrated. Aim for six-eight glasses of fluid throughout the day.
  • Choose foods higher in fibre, such as, porridge oats, nuts, seeds, beans and pulses and fruit and vegetables.
  • Speak to your pharmacist who may be able to prescribe a suitable laxative.

 

How can I eat well to support a return to my usual activity or exercise?

Whatever weight you may be now, getting back some of the muscle you have lost can help give you more energy and strength to slowly become more physically active again. To help fuel your activity, you will need to ensure you have sufficient energy (calories) and protein.

See the section most relevant to you for further dietary advice:

 

What support is there if I’m not well enough to get to the shops?

The NHS Volunteer Responder service may be able to arrange a volunteer to support you with shopping 0808 196 3646.

Many supermarkets now offer food deliveries/online food shopping. Please visit their website to find out more.

In England or Wales, your local council may be able to arrange meals delivered to your home ‘meals on wheels’. Contact your local council to find out more.