If you have a health condition such as diabetes or heart disease, some of the advice in this section may not be suitable for you. Talk to your GP or healthcare professional for more information.

Managing your diet post COVID-19

Symptoms can affect your appetite, which can make it difficult for you to meet your nutritional needs.

The importance of eating well

Making sure you eat well can help with your recovery and to regain strength. If you have a poor appetite and are struggling to eat and drink enough, increasing your calories and protein is more important than healthy eating.

Being overweight or underweight is not good for your health. If you are overweight it is better to focus on recovering first and look to lose weight when you are better.

If you can, keep an eye on your weight to check that you are not losing weight while you are recovering. If you are not able to weigh yourself, keep an eye on other signs that indicate weight loss such as jewellery and clothes becoming looser.

If you are losing weight without trying to, the information in this section can help you to increase your calorie intake, however, if you continue to lose weight or struggle to eat, even if you are overweight, speak to a healthcare professional for further advice.

A healthy balanced diet

Your body needs a range of nutrients for a balanced diet. Having a varied diet with a good intake of nutrients will help you to recover, including regaining weight and muscle strength lost while you were ill.

The Eatwell Guide shows what makes up a healthy balanced diet. You can find the guide at www.nhs.uk/live-well/eat-well/the-eatwell-guide

Fruit and vegetables

Aim for at least five portions a day. Fresh, frozen and tinned vegetables and fruit all count.

If you are struggling to eat enough fruit and vegetables consider taking a multivitamin and mineral supplement.

Consider taking a vitamin D supplement if you are not able to get out outdoors. In the UK a supplement of 10 micrograms of vitamin D a day is recommended.

Carbohydrate foods (starchy foods)

Include a starchy food at each meal. Starchy foods include potatoes, bread, pasta, rice, cereals and puddings. Choose wholegrain versions where possible for extra fibre.

Dairy foods

Try to include three portions of dairy a day. Dairy foods include milk, yoghurt, cream, cheese and fromage frais.

Some non-dairy foods provide the same important nutrients. These include green leafy vegetables, beans (kidney beans and chickpeas), nuts, seeds, oranges, dried figs and tinned fish with bones (salmon or sardines).

Protein foods

Try to eat protein foods two to three times a day. Protein rich foods include meat, fish, poultry, eggs, dairy products, beans, lentils, nuts, tofu, peanut and other nut butters, baked beans, vegan cheese, hummus and plant based milks.

High energy foods contain a lot of calories but don’t give us many other nutrients and are the ones to cut back on if you are trying to lose weight, however, it is important that you fully recover before you start to try to lose weight.

High energy foods are those that are high in fat, sugar or both. If you have diabetes high sugar foods should be limited.

Hydration

It is also important to drink enough to help your recovery. Although you may not feel thirsty, try to drink regularly throughout the day and aim for six to eight drinks daily.

Water, hot drinks, low fat milk, fruit juices and sugar free drinks all count towards your fluid intake but alcohol does not.

Check your urine colour as an indication of hydration. Dark urine is a sign of dehydration. Drink enough fluids to keep your urine a pale straw colour.

Poor appetite

If you are unwell, struggling to eat enough or are losing weight or muscle strength, you may need to eat more protein and calories to help prevent further weight loss and regain your strength.

You may find it easier to eat little and often. Try small meals with snacks in between with a snack or milky drink before bed.

If you have a very poor appetite, try to eat something at each meal and snack time, even if it is only a few mouthfuls. Try to gradually increase the amount you eat every day.

Eating when short of breath

Being short of breath can make eating difficult. The following tips may help you to eat more.

• Try to sit upright when eating.
• Take your time when you are eating and drinking, and breathe evenly.
• Try and eat at the times when you are less short of breath.
• Eat small portions of high calorie, high protein foods, regularly during the day.
• Choose soft, moist foods that are easier to chew and swallow, such as fish pie, cottage pie, casseroles, stews, meals with sauces or gravy, soups, milk puddings, ice cream and puddings with custard or sweet sauces.
• Avoid very hot or cold foods if you find that they affect your breathing or make you cough more.

Eating with a dry mouth

• Choose moist dishes such as stews, casseroles or pasta with sauce.
• Choose softer, easy to chew foods rather than pieces of meat or poultry.
• Add sauces to savoury foods such as gravy, white sauce, cheese sauce, mayonnaise and tomato ketchup.
• Add custard, cream or evaporated milk to sweet dishes or serve with jelly or ice cream.
• Nourishing soups can be easier to manage.
• Try to drink six to eight cups of fluid each day. If you have a poor appetite try to include some nourishing drinks such as milky drinks and juices.

Eating with taste changes

You may have taste and smell changes, which can make eating and drinking less pleasurable. Try these tips if you are experiencing taste changes.

• Eat foods you enjoy but do try other food that you might not usually eat.
• Experiment with herbs, spices, pepper, pickles and chutneys in dishes.
• Try spicy or sharp foods as these have a stronger taste.
• If you find the taste of hot food off-putting, try cold foods instead.
• Try foods that you have previously not enjoyed again, as your taste may carry on changing.
• If you have a metallic taste in your mouth, try using plastic or wooden cutlery.

Shopping

• Ask family or friends for help with shopping if you struggle to shop for yourself.
• Try click and collect or home delivery if shopping is too tiring.
• If you are struggling to shop, cook and prepare meals, you could look into delivered meals in your area, for example Wiltshire Farm Foods or Oakhouse food.
• For days when you don’t feel like cooking or if you are not able to get to the shops, it can be useful to have some foods in your store cupboard or freezer to use in easy meals and snacks.
• Only buy foods that you like and know you will eat.

Further support

If you are concerned about your weight or continue to eat poorly, ask you GP or healthcare professional for a referral to a dietitian for more detailed assessment and advice.

If you have diabetes, the symptoms of COVID-19 may affect your blood glucose control. Diabetes UK has more information at www.diabetes.org.uk

If you take medication for high blood pressure and have lost a lot of weight, it may affect your blood pressure control. Speak to your GP for more advice.

Managing changes to your swallowing (dysphagia)

Following or during COVID-19 you may experience problems with your swallowing. This can impact your eating and drinking as well as management of your saliva.

Common signs of difficulty include:

• repeated chest infections
• choking or coughing during or after eating or drinking
• difficulties with chewing foods or a feeling of something stuck in the throat
• a wet or gurgly voice after eating and drinking
• prolonged mealtimes
• food and/or drink spilling from the nose or mouth
• pain when swallowing
• losing weight unintentionally
• difficulties managing saliva.

Physical weakness due to loss of muscle mass during illness has been seen in COVID-19 patients and can impact your ability to feed yourself, chew or safely swallow food, drink and saliva. Following COVID-19 you may additionally experience:

• tiredness during mealtimes and general fatigue
• changes to taste and sense of smell.

These may take some time to return to normal and should be supported by a speech and language therapist.

We may recommend you change the foods you are eating or the consistency of your drinks to support safe eating and drinking. We can discuss managing excess or not enough saliva with you and your GP.

Problems with swallowing can also be associated with dehydration and malnutrition, so it’s really important to inform your family and GP, so a referral can be made for a swallowing assessment.

If the changes to swallowing are significant, you may need to have short or long-term supplementary tube feeding to support recovery.

Swallowing difficulties may be persistent if long-term respiratory support is needed, for example oxygen therapy or ventilation.

This may also make you more vulnerable to further chest infections. Other changes to respiratory function post COVID-19 can include a chronic cough.

To help, you can try:

• sitting as upright as possible when eating and drinking
• taking your time and focus on eating and drinking, for example turn off the TV
• avoiding straws or cups with lids, unless otherwise advised
• making sure dentures fit correctly
• keeping your mouth clean with regular teeth brushing and good oral hygiene.

Go to leaflet…

• Long Covid
• Managing your breathing
• Managing your cough and clearing your chest
• Tiredness and fatigue
• Emotional impact
• Communication and changes to your voice
• Food and diet
• Quit smoking
• Getting active