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Adapting Lifestyle: Ways to Tackle COVID-19

COVID-19 is a pandemic caused by a virus of corona family. The first case was reported on February 27, 2020, gaining its peak in Pakistan gradually over the months since. The strategy to control any disease from spreading does not include only pharmacological interventions, but many Non-Pharmaceutical Interventions (NPI) as well. NPI includes lots of lifestyle related factors, which can be modified to control the spread of the disease and keep our immune response strong to fight against it. Lifestyle adaptation encompasses all aspects of life but the ones found to be most beneficial in COVID-19 include our nutrition, personal hygiene, physical activity, and mental and social health.

Nutrition
People, who consume a well-balanced diet, use fresh and unprocessed food daily to get carbohydrates, proteins, fats, minerals, vitamins and dietary fiber along with antioxidants, tend to have stronger immune systems and lower risk of illnesses. During the COVID-19 pandemic, the nutritional status of individuals is considered as a measure of resilience toward deterioration. In addition, various dietary ingredients are determinants of gut microbial composition, which are beneficial and subsequently shape the immune responses in the body. 
The professional and authentic dietary guidelines recommended by World Health Organization (WHO) are:
Eat Fresh and Unprocessed Food
•    Eat fresh seasonal fruits like watermelon, cantaloupe melon, mango, banana, papaya, with a serving of two cups (4 servings).
•    Eat 2.5 cups (5 servings) of fresh vegetables (e.g., green bell peppers, garlic, ginger, kale, lime, dried coriander, broccoli, green chili pepper).
•    Eat 180g of legumes (e.g., lentils, beans), nuts and whole grains (e.g., unprocessed maize, millet, oats, wheat, brown rice or starchy tubers or roots such as potato, yam, taro or cassava).
•    Eat foods from animal sources (e.g., 160g of red meat once to twice per week, poultry 2-3 times per week, fish, eggs and milk).
•    For snacks, choose raw vegetables and fresh fruit rather than foods that are high in sugar, fat or salt.
Do not overcook vegetables and fruit as this can lead to the loss of important vitamins. When using canned or dried vegetables and fruit, choose varieties without added salt or sugar.
Hydration
Water is essential for life. It transports nutrients and compounds in blood, regulates your body temperature, gets rid of waste, and lubricates and cushions the joints. Drink 8–10 cups of water every day. Water is the best choice, but you can also consume other drinks, consume fruits and vegetables that contain water, e.g., lemon juice (diluted in water). Unsweetened tea and coffee is also a good choice but be careful not to consume too much caffeine. Avoid sweetened fruit juices, syrups, fruit juice concentrates, fizzy and energy drinks as they all contain sugar.
Eat Moderate Quantity of Fat and Oil
•    Consume foods with unsaturated fats (e.g., fish, avocado, nuts, and olive, soy, canola, sunflower and corn oils) rather than those with saturated fats (e.g., found in fatty meat, butter, coconut oil, cream, cheese, ghee).
•    Choose white meat (e.g., poultry and fish), which are generally low in fat, rather than red meat.
•    Avoid processed meats because they are high in fat and salt.
•    Where possible, opt for low-fat or reduced-fat versions of milk and dairy products.
•    Avoid industrially produced transfats. These are often found in processed food, fast food, snack foods, fried food, frozen pizza, pies, cookies, margarines and spreads.
Eat Less Salt and Sugar
•    When cooking and preparing food, limit the amount of salt and high sodium condiments (e.g., soy sauce and fish sauce).
•    Limit your daily salt intake to less than 5g (approximately 1 teaspoon), and use iodized salt.
•    Avoid foods (e.g., snacks) that are high in salt and sugar.
•    Limit your intake of soft drinks or sodas and other drinks that are high in sugar (e.g., fruit juices, fruit juice concentrates and syrups, flavored milks and yogurt drinks).
•    Choose fresh fruits instead of sweet snacks such as cookies, cakes and chocolate.
Avoid Eating Out
•    COVID-19 is transmitted through droplets spread by coughing or sneezing of an exposed person. Although it is not a food borne illness but it can be transmitted by the delivery boys who may be asymptomatic carriers of the disease.
•    Eat at home to reduce your rate of contact with other people and lower your chance of being exposed to COVID-19. 
•    Droplets from infected people may land on surfaces and people’s hands (e.g., customers and staff), and you cannot be sure of the hygiene measures of these restaurants – if hands are being washed regularly enough, and surfaces are being cleaned and disinfected fast enough.

Physical Activity
The COVID-19 outbreak has resulted in closure of gyms, stadiums, pools, fitness studios, parks and playgrounds. This led to the disruption in routines of physically active individuals, so increasing trends of being less physically active, increased screen time, irregular sleep patterns, and unbalanced diet is resulting in weight gain and loss of physical fitness. WHO recommends 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week for healthy adults. This periodic exercise is very helpful, especially in times of anxiety, crisis and fear, and is also immune booster. Following tips may be helpful to stay active during these times of voluntary lockdowns:
•    For those whose work involves long periods of sitting, or working from home, should move after every 30 minutes at least for two minutes, e.g., by stretching, doing housework, climbing stairs or simply having small walk in the room.
•    Those who have internet access can avail free resources on how to stay active during the pandemic. There are many free tutorials on social media, about stretching, meditation, yoga etc., in which the whole family can participate.
•    Indoor games can be appealing to people of all ages and can be played in small spaces.
•    Another important aspect of maintaining physical fitness is strength training that does not require large spaces but helps maintain muscle strength, which is especially important for older people with physical disabilities.
•    Many fitness studios are offering reduced rates for subscriptions to apps and online video and audio classes of varying lengths that change daily.
People should not wear masks when exercising as it may reduce the ability to breathe comfortably. Sweat can make masks wet, which makes it more difficult to breathe and promotes the growth of microorganism. The important preventive measure is to maintain a physical distance of at least one meter from others.

Mental and Social Health
Isolation and change of normal social life because of the pandemic can compound stress or anxiety, which is further aggravated by fear of getting the infection, and possible loss of family or friends. Faced with new realities of working from home, temporary unemployment, home schooling of children and lack of physical contact with other family members, friends and colleagues is a challenge that is not insignificant in the least.
Since the outbreak, social media were flooded by messages of disease related stories, miseries of people, statistics showing increase in cases and deaths, which further add to mental anxiety. The claims of disease cure with herbs, specific diets further add to confusion. Few tips to cope with mental stress by WHO are:
•    Reassure yourself that it is ok to feel sad, stresses, scared, and angry during the crisis. Talking to people you trust can help. Contact your friends and family.
•    If you must stay at home, maintain a healthy lifestyle including proper diet, getting up and sleeping at the same time daily, exercise and social contact with loved ones (it’s physical distancing, which will save you from the infection and not the social distancing).
•    If you feel overwhelmed, talk to a health professional or counselor and seek help 
•    Limit worry and agitation by lessening the time you and your family spend watching or listening to media coverage as it can be upsetting.
•    Draw on skills you have used in the past that have helped to manage previous adversities of life or learn a new skill to manage your emotions during the challenging time of the outbreak. HH


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