Nutrition’s role in improving COVID-19 outcomes flagged by EFAD

25 May 2020 --- The important role of dieticians in helping to improve COVID-19 outcomes is highlighted by the European Federation of the Associations of Dietitians (EFAD). Good nutrition can help boost recovery and dietitians are experts in assessing the nutritional demands of each individual patient, according to the organization. Moreover, depending on the case, a tailored dietary regime may help boost patient-specific deficiencies and speed recovery. EFAD recently released a briefing to outline the role that dieticians can play in tackling the pandemic.

“Patients who have suffered COVID-19 and been hospitalized will be at increased risk of malnutrition and will likely have suffered loss of muscle during their stay. Dietitians can recommend nutrient rich, fortified, tasty foods or specialist nutrition supplements to help people regain the weight and muscle that may have been lost,” Judith Liddell, EFAD Executive Director tells NutritionInsight.

“Diet and lifestyle measures are not a substitute for current public health advice, but we hope that this briefing will help dietitians, health professionals, health caterers, policymakers and members of the public to optimize nutrition for everyone as we wait for the COVID-19 pandemic to pass,” she adds.

Treating coronavirus patients
Analysis from the International Nutrition Survey has shown that there is a direct correlation between the total number of funded dietitians in intensive care and improved patient care, EFAD says. Malnutrition in COVID-19 patients is a concern that has been continuously flagged.

“Dietitians play a core role in the response to COVID-19, from the frontline in acute care to population level advice and support in acute community care, primary care, food service and education. Dietitians are essential to ensuring that nutrition is delivered in the safest and most effective way for each patient in the ICU and also in the hospital in general,” she adds.

Patients can experience malnutrition, changes in eating patterns during and after critical illness, which can directly impact on recovery and rehabilitation, EFAD notes. Patients in ICU, care homes and their own homes can experience malnutrition, changes in eating patterns, loss of sense of taste and smell and have a poor appetite before, during and after critical illness which can directly impact on recovery and rehabilitation, EFAD notes. 

During the COVID-19 pandemic, critical care dietitians also have a huge role in upskilling and training non-critical care dietitians, to assist in managing the increasing numbers of critically ill patients being admitted to hospital or cared for in the community. “This involves training our colleagues how to assess nutritional status and recommend nutritional support, tailored to each individual patient,” says the organization.  

EFAD also highlights that dietitians have an important role to play in rehabilitation, reducing risk of complications and shortening recovery times. People with pre-existing health conditions, such as malnutrition, cancer, obesity, diabetes, food allergy and eating disorders to name but a few, also require support, even if the COVID-19 lockdown has made it more difficult to access it as they normally would.  

Reinforcing public health
According to Liddell, dietitians are able to lead and make significant contributions to local, regional and national action plans regarding nutrition and food. This ability to work across all sectors gives dietitians a clear advantage over other other professions.

For the many people that are not dealing with COVID-19 or existing health conditions, lockdown presents many challenges, partly because of food shortages and also because of the requirement to reduce frequency of food shopping trips. Accessing or maintaining a healthy diet and getting sufficient exercise during this time is more difficult and early evidence indicates people of all ages are eating less healthily, EFAD says. 

That is why it is so important that public health dietitians continue to provide helpful information and guidance to the public to help them make best use of the food they can access, by promoting healthy and sustainable choices, the organization asserts.

The pandemic is having a much greater impact on poorer members of the community who were already more likely to be suffering from food insecurity, hence the importance of mapping this risk, continues EFAD. For example, research by the UK Food Foundation estimates over three million people in the UK have slipped into food poverty as a result of COVID-19. 

The usual safety nets such as food banks are under greater strain and finding it more difficult to support people while social distancing. Although nobody should be in food poverty, dietitians still have a vital role to both help identify those at risk and to ensure support provides the best nutrition in the circumstances. 

This includes having an updated knowledge of the local nutritional assistance programs, developing healthier menus and advice for families cooking on limited budgets and suggesting ways of reducing food waste for a more sustainable food system. 

Furthermore, dietitians share public health messaging, and collaborate with other organizations to raise awareness of public health issues, such as concern about vitamin D status among those staying indoors for a prolonged period, with governments. NutritionInsight has previously reported on the importance of vitamin D and how over-supplementation may cause health issues.

By Kristiana Lalou