Coronavirus : Nutrition hints and tips for the general public as we face into the current crisis.

Many dietitians are being asked for advice around nutrition during the current coronavirus pandemic. What should we eat to boost our immune system is a common opening question! Simply put, you cannot "boost" your immune system through diet, and no specific food or supplement will prevent you catching Covid-19.  Good hygiene practices, coughing etiquette and social distancing remain the best means of avoiding infection. To date, the European Food Safety Authority have not authorised any claim for a food or food component to be labelled as protecting against infection.

However, there are many nutrients that are involved with the normal functioning of the immune system, so we would encourage maintaining a healthy balanced diet in order to support immune function (include copper, folate, iron, selenium, zinc and vitamins A, B6, B12, C and D).  We don't recommend any one food over another, but instead encourage eating a variety of foods to maintain a healthy balanced diet.

There is NO NEED to stockpile or buy more food than you normally would.  Although you should seek to keep shopping trips to a minimum, if you are not ill and are only undertaking social distancing, you can still visit the shops to but pay normal supplies.  

Check out our tips here for eating well on a budget and using store cupboard essentials - more important than ever at the moment!

Remember to :

• Use up your fresh ingredients first.  You don't want any food to go to waste, so use up perishable ingredients before foods with a longer shelf life.
• Know what keeps longest.  Fresh foods with relatively long shelf life include root vegetables such as potatoes, sweet potatoes, carrots and onions.
• Carefully wash, rinse and drain salad leaves and fresh herbs and spin dry in a salad spinner, place into a suitable plastic storage container, cover and keep refrigerated.  By following this procedure your salads and fresh herbs will last for several more days than if just stored in the fridge uncovered.
• It might seem obvious but make sure you aren't storing things in your fridge that don't need to be in there.  For example, fresh tomatoes, in-peeled onions, un-peeled jacket potatoes, whole butternut squashes don't need to be refrigerated.  Removing these items from your fridge and storing them in a cool dark place will free up fridge space for more perishable items.
• If you are stuck at home, take the opportunity to tidy and declutter your kitchen cupboards to free up space for ambient food products.  This is a great opportunity to get rid of those unused and unwanted items that end up "living" in your valuable storage space.  Remember to recycle as many of the items you are discarding as possible.
• If you do get sick, it is worth having a few easy to cook and prepare foods in the house on standby.  Eggs are a great standby food -  easy and quick to prepare.  Keep bread in the freezer sliced and defrost as needed.

Vitamin D

In normal circumstances, sunshine, not food, is where most of your vitamin D comes from.  So even a healthy, well balanced diet, that provides all other vitamins and nutrients you need, is unlikely to provide enough vitamin D if you aren't able to get enough sun.  During autumn and winter months when we spend more time indoors and the sun is weaker, adults and children over the age old one are advised to take a daily supplement containing 10 micrograms of vitamin D.

Now we are in spring, if you can you should seek to spend some time outdoors in the sunshine (eg. your garden or balcony).  However, if you are having to self-isolate or if you are unable to go outside, you should consider taking a daily supplement containing 10 micrograms to ensure a healthy vitamin D status (for adults and children over the age of one).

You can also eat plenty of vitamin D rich foods, including:

• Oily fish such as salmon, sardines, pilchards, trout, herring and kippers contain reasonable amounts of vitamin D.
• Cod liver oil contains a lot of vitamin D, but don't take this if you are pregnant.
• Margarine, some breakfast cereals, fortified milk and some yogurts have added vitamin D.

Should I be concerned about food safety and Covid-19 transmission?

There is currently no evidence to suggest that the Covid-19 virus is transmitted when handling or preparing food.  Please continue to follow general food safety advice;washing hands thoroughly, cleaning surfaces and separating raw meat / fish from other foods when preparing food.  Safefood have very good leaflets on this topic.

Why is malnutrition important to consider for Covid-19?

• Many people who fall into the at-risk group and have been advised to stay at home, are also those considered to be at greater risk of malnutrition.
• Malnutrition is a serious condition which can increase a person's risk of infection as well as slowing down their recovery.  Those with an infection are also at higher risk of developing malnutrition which slows their recovery.
• Malnutrition is also more common for older people and those who are already socially isolated.  Social distancing and social isolation could impact a person's access to the wide variety of foods needed to keep healthy and may make them want to eat less.
• Unintentional weight loss due to disease or infection is not good, whatever someone's original body weight was.  Healthy eating in older age may look different to the general heathy eating guidelines.  This is because older people are more at risk of malnutrition.  Some older people may need reassuring that their diet should be different.

What is the advice for someone at risk of malnutrition?

It is important older people are still encouraged to keep active.  Good nutrition, including eating enough protein, is essential to protect people's muscles including respiratory muscles to help with breathing. Click for some high protein and high calorie tips from the HSE 'Making the Most of Every Bite' leaflet.  The Making the Most of Every Bite Cookbook by Dr Aoife Ryan, UCC also provides lots of recipe ideas here.

Finally getting enough fluid is essential for good health and you will need more fluid than usual if you have an infection.  Adults are usually advised to have 6-8 mugs or large glasses a day, but this may need to be higher for someone with a high temperature.

(Credits: Some material adapted from BDA website)

In these unprecedented times, there is a need for greater communication of evidence-based information and the sharing of expertise across the Dietetic Community.Many Dietitians will find themselves working in areas that are unfamiliar.  To support you as you navigate this changed landscape, the INDI has formed a task and finish group to develop resources.

These resources are now available for you in our INDI E-Learning centre.

Our aim is to be flexible and evolve documents that are fit for purpose and we welcome suggestions of resources – existing or needed - so let us know if you see any gaps. These documents are in word format so you can adapt them to local PPG.

We have also developed a forum on our Learning Centre to share experience, support one another, and seek knowledge. This forum is private and is not moderated. 

There are two areas in the E-learning centre – one for clinical dietetic practice and one as a signpost for general information which may be useful (non-urgent, non-acute, general healthy eating)

The resources are for use by our members and you can also share them with other Health Professionals and members of the public as needed.

These documents have been developed and/or collated by Dr Anne Griffin, Ruth Kilcawley, Carmel O Hanlon, Jennifer Feighan, Ruth Reidy, Mairead Aherne and Lisa Shanahan using material from a variety of sources.  The resources have also been shared with our colleagues in the BDA and throughout the EU via EFAD.

Huge thanks to all in the group who worked tirelessly over the last few days to prepare these resources for you - we are very grateful for all their efforts.

We hope that you find them useful.

To access the E-Learning Centre: Please follow this link https://learning.indi.ie/course/index.php?categoryid=8  then click on the 'Resources for Dietitians' course and click LOG IN AS GUEST from the login screen.

The Dietitians of the Renal Interest Group of the INDI are delighted to present an opportunity for dietitians to learn from those working in this specialist area of dietetics with their Online Renal Nutrition Course.

Are you planning your CPD for the year ahead?

Would you like some online CPD
to do in your own time on these cold Winter days?

Would you like to upskill
in the area of Renal Nutrition?

Then this new course is for you!

 

Brought to you by the
Renal Interest Group of the INDI

Renal Nutrition Course 1
 Introduction to Chronic Kidney Disease (CKD) 
Stages 1-3A

The very popular and well established renal nutrition course has been revamped and will now be delivered as 3 separate courses (see Table below) covering the full spectrum of nutritional management, from early stages of CKD to end stage renal disease including dialysis and transplantation.  

We are delighted to start 2020 with the launch of Course 1 which will  provide you with the foundation knowledge about the disease from both a medical (pathophysiology, diagnosis, risk factors management) and a nutritional perspective (nutritional assessment, dietary manipulation, aspects of renal diet required in earlier stages and how to incorporate into overall care plans with other co-existing illness).

Course content has been developed by nephrologists and dietitians specialising in nephrology.  This fully online course will be available on demand for a period of 8 weeks from purchase date.  It will be compulsory to have completed course 1 or a similar renal nutrition course before progressing to course 2 and likewise for course 3.  

What is the aim of the course?
 

To educate the dietitian regarding the appropriate medical and dietetic management of patients with Chronic Kidney Disease (Stages 1-3A with focus on stage 3A).

Who is this course suitable for? 

• Dietitians in general, as well as those working in the area of community dietetics, endocrinology, cardiology and care of the older person.
• Dietitians working in the area of nephrology for less than one year or dietitians with an interest in this area.

How long will it take to complete the course?

The course consists of 5 modules (including pre course work), a comprehensive range of supportive resources and a post course assessment. It takes approximately 8 hrs to complete and we recommend that you assign one to two hrs per week over 4-6 weeks to complete it. 

How much does the course cost?
The course is competitively priced at €125 for INDI members and €225 for non members.

Will I get a certificate of completion when I do the course?
A cert can be generated form the training package when you have completed all modules and post course assessment.

To sign up and start this exciting course,
please email the INDI office at
info@indi.ie
to request payment form and log in details.
 

It's that time of year again - always a good idea to rethink the school lunchbox.

Lots of useful hints and tips from safefood here below to inspire you.

Good food habits set early in childhood can last a lifetime. Lunches provide around one third of our daily nutritional needs, so it’s important to put some thought and planning into them. Here are some tips on how to prepare a healthy lunchbox. 

Seven steps to creating healthy, varied and interesting lunchboxes

1. Include a wide variety of foods - starchy foods, protein, dairy, and fruit and vegetables
2. Try to offer different foods every day - no one wants to be eating a ham sandwich five days a week!
3. Vary the types of bread e.g. pitta bread, bagels, wholemeal rolls - keep a stock in the freezer 
4. Cook extra rice/pasta in the evening - these can make interesting salads
5. Theme your lunchbox on a different country, e.g. Italian - try a pasta salad, Mexican fill flour tortillas
6. Home-made soup (in a Thermos flask) is great for cold days, while salads are light and refreshing for warmer weather. Both are packed with essential vitamins and minerals 
7. Fluids are important for children - up to 6 cups of fluid should be encouraged daily. Milk and water are the best options. Straws and brightly coloured drinks bottles can make rehydrating more interesting!

Five steps to food safety

Make sure your child's lunchbox is clean and safe. Remember that sandwiches containing meat or other foods that require refrigeration should be kept as cold as possible until lunch. Help keep lunches cool and safe by following these tips:

1. An insulated box or bag can be used to help keep lunches cool. A small ice pack can also be used or alternatively include a frozen fruit juice carton
2. It is important that lunches are not kept in a warm place such as near radiators or in direct sunlight
3. Discard any perishable food that hasn’t been eaten at the end of the day
4. Wash and dry reusable water bottles, lids and lunchboxes every day in warm soapy water.
5. And last, always remember to wash your hands before eating lunch. Here's what should go in a healthy lunchbox.

Need more lunchbox ideas?

• Lunchbox planner (PDF, 2.6MB)
• "Healthy lunchboxes" leaflet - ROI (PDF, 1.5MB)
• "Are you packing a healthy lunch?" leaflet - NI (PDF, 2.6MB)
• Healthy Lunchboxes leaflet - Irish (PDF, 400KB)

As you may be aware, a HSE Working Group for Changes in Dysphagia Management, reporting to Dr Colm Henry, HSE Chief Clinical Officer (CCO), has been working on a plan to support the transition to the International Dysphagia Diet Standardisation Initiative Framework (IDDSI,2015) starting September 1st 2019.

Please find details below on how to access the share centre on hseland.ie where educational and training resources to support staff in implementation of the transition to International Dysphagia Diet Standardisation Initiative Framework (IDDSI).