Coronavirus and Eating Well

Written by Laura Coster, a Registered Dietitian in collaboration with Fittleworth Medical.

It’s understandable that some of you may be feeling a little anxiety around food at the moment and I wanted to empower you all to feel confident in eating well during this time. This advice is to help you structure your meals to look after your health, but also on how to better access food and create meals that you enjoy from what is available in your area. My family and I use these tips and I have tailored them to be mindful of those of you with stomas or those who you care for.

1) Eating and drinking for health

Eating a well-balanced diet and staying hydrated is important for both our physical and mental health, but especially for an efficient immune system. The recommendations from our nutritional guide are there to enable you to provide your body with the right balance of nutrients. They are also adapted to help you adjust your food choices for your personal needs e.g. a lower tolerance to bowel and bladder irritants or fibre.

To boost your confidence when shopping and swapping ingredients, you might like to write your swaps on your shopping list too e.g. write ‘courgette’ and next to it ‘or aubergine’.

Across a day, continue to base your three meals on a portion of protein, a starchy carbohydrate and vegetables. If you’re able to, aim to meet your ‘5 a day’ by having three or more vegetables and the rest from fruit – this is to balance between providing nutrients while being mindful of fruit’s natural sugar. Consume between two and three portions of dairy foods, or its fortified alternatives like fortified soya milk, to meet your calcium needs. Finally, continue to drink 6 to 8 cups of hydrating fluids a day or however much your specific target from your designated medical professional is.

It is not advisable to take any supplements unless you have been given explicit advice by your Doctor, Dietitian or Specialist Stoma Nurse. Supplements can interact with certain medications and there is no strong clinical evidence that they help reduce your risk of catching coronavirus or how quickly you’ll recover. The best way to fuel your immune system is to eat healthily and stay hydrated. The British Dietetic Association’s website has some information about supplements as well as overviews of various nutrients you may be interested to learn more on.

2) Preparing for success

Meal planning is a great way to help us eat well at any time and is especially valuable now. When we plan ahead for what we’ll eat, we can then write a shopping list that ensures we buy enough for ourselves without depriving others.

Many of us meal plan to some degree unconsciously and it’s probably easier than you think. There are in-depth guides across the internet, but a simple approach is to draw a grid showing each day of the week as well as the meal timings and then fill this in with what you and your family would like to eat – from these meals or recipes you then write your shopping list. To reduce food waste and how many different ingredients you have to buy, it is helpful to plan meals with similar ingredients across a couple of days e.g. having a roast chicken dinner on a Sunday and using the leftover chicken for sandwiches the next day or our chicken stir fry for Monday’s dinner. You might like to include your fresh ingredients earlier in the week and make meals with frozen or cupboard-stored foods later in the week. I like to batch cook soups, stews and curries and these reheat well for the next day or two, but they also freeze well to then have a few days later.

If you’re unable to tolerate standard sized meals or are trying to recover after surgery and regain weight, do include any snacks if you need these e.g. you can use eggs for an omelette as a meal but also have a couple of boiled eggs as a snack.

3) Be food-flexible

Depending on your confidence with cooking, you may feel comfortable in being able to make last-minute swaps to ingredients if your preferred choice is out of stock. For those who need inspiration, my suggestion is to think of similar substitutions e.g. swap fresh for frozen/tinned or for an alternative in its food group. In the ‘Fibre & Irritant Food and Drink Table’ in our nutritional guide, we have categorised foods between those that are likely to be less irritating to your bladder or bowel or more so. We have also organised this according to the various food groups and give multiple examples of foods within these which can serve as your substitution ideas.

Try replacing fresh beef mince for another meat, frozen options or even soya mince*. Rice noodles or spiralised courgette* can replace wheat/egg noodles, bulgur wheat*/couscous*/pearl barley* instead of rice, make roasted butternut squash* instead of roasted potatoes or use polenta to make ‘mashed potatoes’. If you tolerate milled or ground seeds but you can only buy them whole, you could use a food processor or mortar and pestle to grind these yourself. Some of these food swaps are a little higher fibre* and so consider your personal tolerance level.

For vegetables, you could swap one for another e.g. carrots for parsnips, replace fresh peppers for frozen or roasted peppers in jars. If passata isn’t available, you can lightly blend tinned chopped or plum tomatoes and sieve out the seeds if there are any. Be open to more ‘unconventional’ options too like using beetroot to make ‘no-mato’ sauces – just a note, this can redden your stoma output but is nothing to worry about. In our home, we have been using kefir instead of pouring yoghurt and as an alternative to soya yoghurt we use a recipe to make our own from silken tofu, a banana, some soya milk and lemon juice.

To boost your confidence when shopping and swapping ingredients, you might like to write your swaps on your shopping list too e.g. write ‘courgette’ and next to it ‘or aubergine’.

4) Be fresh-food savvy

As we’re following the government’s advice and shopping less frequently, we can make our fresh food last longer through some simple steps. This could involve batch cooking and chilling/freezing, but various ingredients can be frozen at home and still be high quality when we later prepare them to eat. Many people are familiar with freezing meat and some fruits like berries, but did you know that you can freeze bread, milk, yoghurt, hard cheeses after slicing or grating, falafel, non-watery vegetables, cooked sweet potatoes and fresh herbs? Slice bananas before freezing and you can then add these to our overnight oats or green smoothie recipes without pre-defrosting. Toasters often have a defrost setting and you can eat your bread slightly warm for a near ‘just baked bread’ experience or you may prefer to let it cool.

For more suggestions of how to freeze and defrost certain foods you might like this BBC guide. As always, food hygiene is important and the Food Standards Agency website has useful information on this.

5) Shake-up how you shop

Although a supermarket can seem convenient, if there are long waiting times or you can’t buy all you need there then it’s worth having alternatives. Consider shopping more locally as small businesses such as butchers, greengrocers and cultural-food shops have similar and often the same produce as what you would usually buy. These small businesses are often located near one another and the distance you walk inside them and going between these shops can be less than what you would walk across a whole supermarket. If possible, you could split your food shop with different members of your household, and you could each visit one or two different shops to get what you need.

Prices for items vary depending on your local area and sometimes you will pay less for higher quality foods at a local shop compared to its supermarket equivalent. Occasionally you may pay slightly more for a food shop from your local businesses, but at these smaller places you may find more items from your shopping list and so this small increase in cost might feel reasonable. If you’re still receiving a similar income and spending less elsewhere in your budget, e.g. not eating at restaurants, this could also cover an adjustment in your food shopping cost.

6) Make eating enjoyable

Food is as much about enjoyment as it is nourishment, therefore meals should be both well-balanced and satisfying as this helps reduce overeating and emotional eating. Choose recipes everyone will appreciate and consider getting your family involved in the meal planning as well as the cooking.

As we’re spending more time at home, we can take advantage of this and re-create our favourite meals we might have eaten out or had delivered. For healthy eating to be sustainable there must be flexibility whereby we mostly eat whole and minimally processed foods and drinks, but then have other options in moderation amongst our well-balanced diet. Many takeaway or restaurant-style meals and desserts can be recreated at home and there is a plethora of recipes online for these. To give you some ideas, we have our chicken curry, turkey burger and vanilla panna cotta and berry compote recipes that are low in fibre and irritants of the bladder and bowel.

If we want to take this opportunity to refrain from processed foods and drinks as well as alcohol then this is great, however, for others this total exclusion can increase anxiety through feeling overly restricted. A compromise is to include such items on our shopping list in reasonable amounts while being mindful of our health. As an example, my partner and I include dark chocolate as part of our food shop to have a couple of squares a few nights a week.

Food for thought

Amongst the circumstances, I have reignited my love of cooking and encourage you to find pleasure in experimenting with food too. For our mental wellbeing it’s important that we appreciate where we can make a difference to our quality of life and food is a powerful way to do this. From everyone in the Fittleworth team, we wish you and your loved ones all the best to keep safe, nourished and well.