Endlich kommen offizielle Empfehlungen zur Ernährung, Mikronährstoffen und Bewegung bei COVID-19

Imsbesondere der Absatz zu Vit.D,A,E, B6/12, Zink und Selen etc. freut mich natürlich sehr. Wir messen und optimieren diese Parameter seit > 1 Jahrzehnt in unserer Praxis.

Defizite gibt es bei fast jedem Patienten, nicht nur bei „Mangelernährung“ – ausser bei schwerer Krankheit fehlt es den meisten Deutschen sicher nicht an Kalorien und Fettgewebe:

„(…) 2.3. Statement 3

Subjects with malnutrition should ensure sufficient supplementation with vitamins and minerals.

Part of the general nutritional approach for viral infections prevention is supplementation and/or adequate provision of vitamins to potentially reduce disease negative impact [15].

As potential examples, vitamin D deficiency has been associated with a number of different viral diseases including influenza [[16][17][18][19]], human immunodeficiency virus (HIV) [20] and hepatitis C [21], while other studies questioned such a relation for influenza [22,23]. The COVID-19 was first identified in Winter of 2019 and mostly affected middle-aged to older adults. Future investigations should confirm whether insufficient vitamin D status more specifically characterizes COVID-19 patients and is associated to their outcome. In support to this hypothesis, decreased vitamin D levels in calves have been reported to enhance risk for bovine coronavirus infection [24].

As another example, vitamin A has been defined as “anti-infective” vitamin since many of the body’s defenses against infection depend on its adequate supply. For example, vitamin A deficiency is involved in measles and diarrhea and measles can become severe in vitamin A-deficient children. In experimental models, the effect of infection with infectious bronchitis virus (IBV), a kind of coronaviruses, was more pronounced in chickens fed a diet marginally deficient in vitamin A than in those fed a diet adequate in vitamin A [25]. In addition, it has been reported that vitamin A supplementation in humans reduced morbidity and mortality in different infectious diseases, such as measles, diarrheal disease, measles-related pneumonia, malaria and HIV/AIDS infection. To this regard, the COVID-19 pandemic has further raised the question of how the infection may impact people living with HIV/AIDS. Where the HIV/AIDS is well managed with adequate treatment, the risk of complications of COVID-19 does not increase. However, in many parts of the world, people living with HIV/AIDS receive sub-optimal treatment and are more likely to have severe complications. There is evidence that ensuring food and nutrition security for all, but particularly for people living with HIV/AIDS will enhance their resistance to other infections by boosting their immunity [26]. Thus, healthy nutrition should be one of the main objectives to protect people living with HIV/AIDS from the potentially lethal consequences of COVID-19.

In general, low levels or intakes of micronutrients such as vitamins A, E, B6 and B12, Zn and Se have been associated with adverse clinical outcomes during viral infections [27]. This notion has been confirmed in a recent review from Lei Zhang and Yunhui Liu [15] who proposed that besides vitamins A and D also B vitamins, vitamin C, omega-3 polyunsaturated fatty acids, as well as selenium, zinc and iron should be considered in the assessment of micronutrients in COVID-19 patients.

While it is important to prevent and treat micronutrient deficiencies, there is no established evidence that routine, empirical use of supraphysiologic or supratherapeutic amount of micronutrients may prevent or improve clinical outcomes of COVID-19. Based on the above combined considerations, we suggest that provision of daily allowances for vitamins and trace elements be ensured to malnourished patients at risk for or with COVID-19, aimed at maximizing general anti-infection nutritional defense.

Quelle: https://reader.elsevier.com/reader/sd/pii/S0261561420301400?token=8C82A9DE10FE9AC431B94D450252F68609141460C3A1F1B17E1D28247788404D365B1C6FA5607DB3F73B2B9DE8CA369