Immunity nutrition cystic fibrosis and COVID 19
9 Apr
Clinical care

Immunity, nutrition, cystic fibrosis and COVID-19

9 April 2020

With the coronavirus pandemic happening, you have probably been wondering if there is anything you can do help “BOOST” the immune systems of your family members with cystic fibrosis (CF). In this article, Tasmanian’s two dedicated CF Dietitians (Lauren Farquhar and Nicole Saxby) have teamed up to give you some practical advice.  

This resource has been modified and endorsed by Dietitians New Zealand Cystic Fibrosis Special Interest Group and New Zealand Child and Youth Cystic Fibrosis Clinical Network Group.

Unfortunately, there is a lot of misinformation and unsafe advice around during this difficult time. Go to the NZ Ministry of Health website at covid-19.govt.nz for the latest up to date information and answers to frequently asked questions.

 

How CF affects the immune system

Most people with CF have good immune systems, except for those post transplant who are immunosuppressed. Having cystic fibrosis does not limit the body’s ability to fight viruses such as the common cold and the novel coronavirus.

However, people with CF are at increased risk of lung infections post viral infections due to interactions between their immune systems and inflammation. Inflammation spurs the creation of more mucus, which can block the airways and allow infection to grow.

 

The role of nutrition in immune function

Optimal nutrition is essential for adequate function of the immune system. There are many nutrients that are involved with normal functioning of the immune system and therefore we encourage eating a variety of healthy foods each day in order to support immune function.

 

What diet should I be following for my child/adolescent/adult with CF during the COVID-19 pandemic?

People with CF have specific nutrition needs (usually high fat, high energy and high salt). It is important that you continue to follow the dietary recommendations made by your CF team.

Maintaining optimal fat-soluble vitamin status is important for people with CF. Many people with CF will be on a regular vitamin supplement (e.g. VitABDECK, Sastra). Some additional suggestions for maintaining fat-soluble vitamin levels:

Vitamin D – fundamental to good bone health and immune function

Get out in the sunshine over winter before 10am and after 3pm (with skin exposed and without sunscreen) - walk the dog, do some gardening. And remember to take additional vitamin D supplements if they are prescribed as well as VitABDECK.

Vitamin A – vital for night vision

Good food sources of preformed vitamin A (retinol) include chicken pate, polyunsaturated margarines, butter, double cream, egg yolk, sour cream, cheese, and full cream milk. Vitamin A in these foods is easiest for the body to absorb.

Good food sources of provitamin A (beta-carotene) include orange and red coloured fruit and vegetables – think sweet potato, carrots, tomatoes and tomato paste. Homemade pizza anyone?

Vitamin E – an important antioxidant

Fats/oils (sunflower, olive, peanut, margarine, butter), nuts/seeds/legumes (sesame seeds, sunflower seeds, almonds, peanuts, peanut butter, soya beans lentils), whole grain breads and cereals all provide good sources of Vitamin E.

Vitamin K  vital for normal blood coagulation and important for good bone health

Green leafy vegetables provide good sources of Vitamin K, these include vegetables such as parsley, silverbeet, spinach, coriander.

 

Can I boost my immune system through diet?

Simply put, you cannot “BOOST” your immune system through diet and no specific food, supplement or health product will prevent you from catching COVID-19. Proper hygiene can help reduce the risk of infection or spreading infection to others.

 

What nutrition advice would you give for someone who is self-isolating?

If you are self-isolating and especially if you have symptoms, it is important to maintain good nutrition and hydration. Make sure you are eating and drinking regularly, with additional salt supplementation  even if you have a low appetite.

 

Ways that the CF community is being supported to access food

Families affected by CF in ­New Zealand are able to access the Countdown priority-booking delivery initiative for people in the community with health issues so they can obtain essential supplies from their supermarket.

If you would like to register for this service, make sure you have signed up for online shopping at shop.countdown.co.nz, then email susan@cfnz.org.nz who will supply you with a specific code set up for CF families. Complete this form and enter the code where it asks for a Super Gold Card number. 

Please only use this service if you absolutely need to – reserved delivery slots should be left open for other New Zealanders who can’t leave their homes at this challenging time.
 

Pantry ideas and what should I do to prepare?

We recommend that you stay at home and go grocery shopping (online and delivered) once a week. Ideally your food choices should be both healthy and high energy if you need it – and make sure you include your favourite foods in your weekly shop.

Continue to buy your usual amounts so there is enough for everyone. There is no need to panic buy food as ­New Zealand has good supplies. Add a few extra easy to prepare foods and canned foods each time you shop to help with variety & food preparation.

Foods such as:    

  • dried pasta and sauce
  • prepared canned soups
  • canned vegetables and beans
  • cheese
  • yoghurts
  • chocolates, biscuits
  • frozen meals.

Note: there are restrictions on the amounts of you can buy at one time for some foods.

Having these supplies on hand will ensure that you do not need to leave your home at the peak of the outbreak.

 

Should I continue to breastfeed my baby?

Visit the Plunket website for the latest information for families on virus transmission and breast and bottle feeding: Frequently asked questions: What do I do if I have COVID-19 but I'm breastfeeding/formula feeding?