This resource is not intended to diagnose or treat disease and makes no claims regarding the prevention or treatment of COVID-19. This information is to help build resilient immune system function. You should always consult your healthcare team before undertaking any nutritional regimen. Many personalized nutrition practitioners are taking new clients virtually. Connect through the ANA's Practitioner Finder.

What role does personalized nutrition play in immune resilience?

Personalized nutrition is the first line of defense against chronic conditions including cardiovascular disease, hypertension, and diabetes. (Source) These conditions may also predispose COVID-19 patients to more severe symptoms and worsened outcomes. (Source, Source, Source) Chronic and infectious diseases like COVID-19 share several features including widespread inflammation and impaired immune system function. (Source) 

Personalized nutrition can play an important role in optimizing immunity and preventing and managing inflammatory chronic conditions in high-risk groups. (Source) 

The effects of nutritional interventions in the progression of chronic diseases can take weeks, months, and even years in some cases. We do not suggest that personalized nutrition is a magic bullet to a global viral pandemic, however, personalized nutrition strategies beneficially influence the interplay between biology and nutrition. (Source) As many writers have noted, we want to reduce the number of cases that burden our healthcare system at a given time. Improving your resilience and reducing the severity of comorbidities with personalized nutrition before infection can help to promote your overall health and resilience, and hopefully flatten the curve of infection. Of course, good hygiene, social distancing, and precautions taken when you go out in public remain critically important.

Each of us responds differently to foods and nutraceuticals based on the uniqueness of our genetic expression, lifestyle, and other factors. We’re also learning that not everyone responds the same way to infection by the virus that causes COVID-19. Reports from Iceland, where testing has not been limited to symptomatic patients, suggest that about 50% of infected people may have mild or no symptoms. (Source) This has provided a new perspective on how widely the virus is spreading throughout the population. And yet as discussed, people with underlying conditions such as diabetes, heart disease or hypertension, chronic lung diseases like asthma and COPD, kidney disease, and impaired immune function may be at higher risk of severe infection and complications. (Source)

This is why it is imperative that you work with a personalized practitioner who understands your immune function, inflammatory status, insulin regulation, and nutrient status. Please do not take supplements, whether nutrients, herbs, or other compounds without consulting your care team. The effectiveness of supplements can be altered by product quality, concentration of active ingredients, and interactions and should be personalized for you by a professional. 

“...the way we live and interact with our environment is the major determinant of both our individual and collective health.” - Jeffrey Bland, PhD, CNS, FACN, FACB

General Guidance for the Public

There are no known preventive, curative, or confirmed therapeutic agents for COVID-19, however, researchers are exploring anti-viral therapies and vaccine trials are underway with some promising leads. (Source, Source, Source, Source, Source) The most important thing we can do is to stay healthy by whatever means we can.

• Follow CDC guidelines. Practice good sanitation like frequent and thorough hand-washing and take social distancing seriously as long as it is recommended. 
• Clean well and clean often. Wear gloves or wipe down cart handles. Wipe down household surfaces, phones, laptops, bathrooms, doorknobs, etc. frequently with alcohol, hydrogen peroxide, and other cleaning agents. These agents can kill the virus, which can live a few days on surfaces. 
• Wear a mask in public. Recent reports suggest that this coronavirus can live outside the host longer than other viruses, and that it is airborne. Experts and the CDC now recommend wearing a good-quality, non-surgical mask when leaving the house. (Source)

Nutritional Considerations

The following is general information about the actions of certain foods, nutrients, and compounds. Please focus on food first, and use caution before introducing any of the following measures. These should not replace formal, personalized advice that considers your health status, health history, medications, and supplements. Again, information is not intended to diagnose, treat, or prevent any condition and should be discussed with your healthcare team and physician.

Again, no foods, nutrients, or supplements have been shown to prevent or mitigate this virus, but many play supportive roles in immune function, especially for those individuals with nutrient deficiencies or nutrient-poor diets. By optimizing our health, we may be able to reduce the strain on our overburdened healthcare system.

10 Positive Steps to Health 

Americans seem to be turning to comfort and convenience foods during this time of hunkering down. (Source) Instead of relying on shelf-stable and processed foods, focus on eating real foods that can build resilience and optimize your immune function. Choose fresh or frozen foods whenever possible. We’ve highlighted 10 areas of focus to help support your wellbeing and overall health:

1. Eat colorful, whole, unprocessed plant foods.

Fruits, vegetables, and some grains provide important nutrients for immune function such as flavonoids like quercetin, vitamin C, and vitamin A, and vitamin D*. There are over 6000 flavonoids that contribute protective benefits and colorful pigments to fruits, herbs, vegetables, and medicinal plants. (Source) Leafy green vegetables like kale and spinach, broccoli, avocados, butternut squash, sweet potatoes, red onions, tomato; fruits like guava, kiwi, bell peppers, strawberries, oranges, papaya, grapefruit, persimmon, pineapple, and apples; and herbs/spices like dill, fennel, oregano, pepper, and cinnamon are excellent sources of these compounds. Beverages such as black tea, green tea, red wine also contain a variety of flavonoids with a variety of benefits. (Source, Source)

2. Include healthy fats that provide antioxidants and anti-inflammatory compounds.

• Nuts and seeds provide selenium and vitamin E: Whole or unprocessed ground nuts and seeds like Brazil nuts, sunflower seeds, and almonds provide important nutrients that support immune health via their antioxidant properties.
• Fish and fish oil contain compounds such as EPA, DHA, and lipid mediators that support immune function generally and are critical to the resolution of inflammation. (Source)
• Coconut oil is generally considered anti-viral. (Source) You can cook with coconut oil or blend it into your coffee. Choose cold-pressed and unrefined products and do not heat any oil beyond its smoke point (approximately 177 °C/350°F for coconut oil). Doing so may increase the formation of volatile compounds that cause negative health effects. (Source)
   

3. Choose high-quality proteins, which are essential for immune function.

• Protein can be derived from animal foods or combinations of complementary plants like beans and rice or lentils and quinoa. Undenatured whey protein can also promote immune health by the action of naturally present compounds with antioxidant and antiviral properties. One serving of high-quality whey protein contains almost half of a healthy adult’s protein needs. Whey protein can be stored dry and can last several weeks, making it a great functional bulk food option. (Source) 
• Zinc is a critical nutrient for immune function that is abundant in some animal foods like oysters, beef, crab, and lobster.
   

4. Feed your microbiome. 

The composition and function of the microbiome can be rapidly altered by what we eat, for better or for worse. Many plant foods like onions, garlic, avocado, beans/legumes, oats, flaxseeds, and root vegetables contribute soluble fiber to our diets, which feeds the beneficial microbes in the gut. These microbes exert influence over the immune system, so it’s essential to keep them healthy. (Source) Unfortunately, Western diets may be limiting the ability of these microbes to protect us (Source) For example, non-nutritive/artificial sweeteners such as saccharin and sucralose have been shown to impact the composition of the gut microbiome and should generally be avoided. (Source) Some general principles apply to support immunity via the microbiome: include prebiotic fibers like the ones mentioned above, and include probiotics from foods like lacto-fermented vegetables (think sauerkraut, kimchi, fermented pickles, kombucha, kvass, etc.) and fermented dairy/non-dairy products. Look for the words “live and active cultures” on labels or make your own lacto-ferments at home! 

5. Cut out sugars.

One of the best things you can do to improve the quality of your diet is to avoid sugars including sodas, fruit juices, and desserts. Sugar can suppress the action of white blood cells in your immune system for hours after you eat it. Focus on real foods, and work with a practitioner if you’d like support managing cravings and blood sugar dysregulation.

6. Get cooking! 

With more time spent at home, many of us have new opportunities to practice new skills and recipes. Get creative by including kids in the kitchen, or video-chat a friend and cook together! (Source) 

7. Drink plenty of filtered water.

Clean water is crucial. Aim to drink about half your body weight in ounces each day (i.e. if you weigh 150lbs, aim to drink 75oz of water daily).

8. Practice self-care and stress reduction.

Stress is an important factor in immunity since stress hormones such as adrenaline and cortisol weaken immune function. During times of stress, we may actually need more nutrients, reemphasizing our need for a variety of whole, unprocessed foods. Practice mindful eating, and notice if you have started heading for sugary, salty snacks. This is a difficult time, and if you notice that you are eating as an emotional response instead of experiencing physical hunger, you may consider speaking with someone who can help or expressing stress in other ways like physical activity, meditation, art, and engaging with loved ones. (Source)

9. Get adequate sleep, exercise, and rest.

Doing so may promote feelings of wellbeing and promote a parasympathetic response. Social isolation can increase fears and feelings of loneliness, acting as immunosuppressants. (Source)

10. Find ways to engage with loved ones.

Share time with your favorite people, whether virtually or in-person with those in close proximity. When we feel loved, relaxed, and happy, we produce neuronal signaling molecules such as serotonin, dopamine, and relaxin which have a strengthening effect on the immune system. (Source)

*Nutrient Spotlight: The Sunshine Vitamin

Vitamin D is getting a lot of attention due to its role in reducing the risk of acute respiratory tract infections, especially in those who are vitamin D deficient. (Source) Optimizing vitamin D status is a safe and likely helpful measure for protecting against respiratory infections in general. Most people do not have optimal levels of Vitamin D, especially in the winter and early spring. (Source) Vitamin D is best produced through exposure to sunlight, and supplementation can be helpful if 25-hydroxy vitamin D levels are suboptimal. (Source) If supplementation is your best option, your practitioner can help you determine your vitamin D status, which will determine dosing. If you have safe access to the outdoors, get outside for at least 20-30 minutes a day. If you find yourself mostly indoors, sit by an open window to catch some rays of sunlight. Connect with a personalized nutrition practitioner.