18/05/2020
Personalised Nutrition and the COVID-19 Era
https://theana.org/COVID-19
Vitamin A - Vitamin A supports the health of mucosal tissues and barrier function. Retinoic acid, a metabolite of vitamin A, also helps regulate the immune system via the microbiome. Theoretically, since COVID-19 appears to impact mucosal tissues throughout the body, vitamin A could potentially be a supportive nutrient to protect barrier function. ACE2 is the cellular receptor for SARS-CoV-2, and animal studies suggest that the ACE2 receptor may be upregulated by all-trans retinoic acid (ATRA), a vitamin A derivative.
Food: Beef liver, cod liver oil, sweet potatoes, carrots, black-eyed peas, spinach, broccoli
Supplementation: Vitamin A compounds with retinoic acid and the carotenoid lutein may be superior. Lutein is a potential 3CLpro inhibitor.
Vitamin C - Vitamin C is an important nutrient for immune health, specifically for white blood cells to fight infections. It also enhances iron absorption, and adequate iron can help protect against vulnerability to infection.
Food: Guava, kiwi, bell peppers, strawberries, oranges, papaya, broccoli, tomato, kale, grapefruit, persimmon, spinach, pineapple
Supplementation: Mega-doses of oral vitamin C have not been shown to protect against coronavirus, although trials are currently underway testing the ability of intravenous vitamin C to protect against the effect of a cytokine storm. Generally, vitamin C is supportive of the immune system, especially in those who are deficient. Buffered, non-acidic or Ester C supplements with bioflavonoids are superior.
Vitamin D - In a systematic review assessing the overall effect of vitamin D supplementation on the risk of acute respiratory tract infection, Vitamin D supplementation reduced the risk of acute respiratory tract infection among all participants (over 11,000 participants ages 0-95). The most benefit was seen in those who were very vitamin D deficient and those not receiving mega-doses. Optimizing vitamin D status is likely a safe and helpful measure for protecting against respiratory infections in general. Vitamin D status should determine dosing so that optimal levels are maintained for the individual.
Supplementation: Most people do not have optimal levels of Vitamin D, especially in the winter. Vitamin D is not found in sufficient amounts in most foods, so exposure to sunlight is important and possibly supplementation if 25-hydroxy vitamin D levels are suboptimal.
Vitamin E - While not specifically an anti-viral nutrient, vitamin E is one of the most efficient antioxidants and plays an important role in lung and liver protection. As a fat-soluble nutrient, it can accumulate in lipid membranes and react quickly with free-radicals that trigger nuclear factors that produce cytokines. Deficiencies can alter immune responses and contribute to increased viral load.
Food: Sunflower seeds, almonds, avocados, spinach, butternut squash, kiwi, broccoli, olive oil, trout, shrimp
Supplementation: Vitamin E has various forms. Combined products with tocopherols and tocotrienols are superior.
Selenium - Selenium is a potent antioxidant and a cofactor of glutathione peroxidase, an important antioxidant enzyme. A deficiency of selenium can alter the immune response and increase the pathogenicity of a virus.
Food: One Brazil nut can provide the daily dose of selenium. Also tuna, shellfish, eggs, sunflower seeds, and shiitake mushrooms are good sources.
Supplementation: Selenium is available in supplement form, and is often included in multivitamin formulations.
Potassium - Potassium is not likely to be a preventive strategy, and may be especially beneficial in for severe cases when the patient becomes hypokalemic due to excessive potassium loss. Healthy individuals can maintain potassium levels by eating a diet that includes:
Food: Cooked spinach, cooked broccoli, potatoes, sweet potatoes, mushrooms, peas, cucumbers, zucchini, eggplant, pumpkins, bananas, oranges, cantaloupe, honeydew, apricots, grapefruit
Supplementation: Supplementation has currently only been explored in the critically ill and those with severe cases of COVID-19 in order to replenish levels of this nutrient when ACE2 receptors are degraded by the virus.
Zinc - Zinc may improve the chance of avoiding respiratory tract infections in the elderly and those who are zinc deficient.
Food: Oysters, beef, crab, and lobster, and to a lesser extent chicken, cheese, kidney beans, garbanzo beans, cashews, and almonds
Supplementation: Zinc can be taken alone, in a multivitamin, or as a lozenge.
Prepared by the Personalized Nutrition & COVID-19 Task Force of the American Nutrition Association
