Diet and Immune System

Croí Banners

Can diet help ‘boost’ our immune system to fight COVID-19?

While it is true that poor nutrition can hamper your ability to fight off illness and infection, it is misleading to think that a special food, nutrient or supplement can “boost” your immune system. There are many products being heavily promoted as “immune boosters”, however immunology is complex and there are no supplements or natural health products approved to treat or protect against the COVID-19 virus.

Alongside a healthy sleep pattern, regular physical activity and stress management strategies, now more than ever is a good time to develop a healthy eating routine.

A Balanced Diet

Following the key points below for a healthy balanced and varied diet with adequate energy and protein intake is important to best support your immune system and overall heart health.

  • Aim for 5 – 7 portions of fruit and vegetables per day (aim to include at every meal)
  • Choose brown and wholegrain versions of carbohydrates
  • Include 2 servings of lean protein per day e.g. fish, lean red meat and poultry, peas, beans, lentils and eggs)
  • Stay hydrated with water as your main fluid source
  • Limit high sugar/fat/salt foods to a few times per week

Below, we will take you through some of the key nutrients found in a balanced diet one and highlight the role they pay in supporting your immune system to work properly.

Click the image to download the Healthy Ireland Food Pyramid.
Click the image to download the Healthy Ireland Food Pyramid.

7 key nutrients for a healthy immune system

Protein is important for many bodily functions such as healing and repair and maintaining healthy muscle mass. It also has a role in the formation of antibodies that fight infection and disease.  Protein foods can be animal based such as meat, fish, poultry, eggs and dairy or plant based such as peas, beans, lentils, tofu and nuts. Vary your protein sources, choose lean meats and poultry and limit processed red meats to keep your diet low in saturated fat. Include fish twice a week one of which is oily such as salmon, mackerel, trout or sardines (tinned or fresh).

1

This vitamin is ace at supporting your immune system! It helps maintain the structure of the cells in the skin, respiratory tract and gut. It acts as an anti-oxidant which is kind of like anti-rust protection for our bodies cells, keeping them strong and ready to fight infection. Beta-carotene which is converted to vitamin A in the body is found in leafy greens, yellow and orange vegetables like pumpkin and carrots.

2

Vitamin E is also a powerful anti-oxidant and is found in green leafy vegetables such as spinach and broccoli. It is also found in avocados and vegetable oils such as sunflower and rapeseed oil and nuts and seeds including: almonds, hazelnuts and pumpkin. Why not try adding a handful of nuts or seeds to your cereal or using rapeseed oil in cooking and salad dressings.

3

Habitual vitamin C supplementation may help with the common cold by reducing severity and duration (>200mg/day) however we don’t know if this transfers to viruses. The recommended daily allowance (RDA) of vitamin C for most adults is 80mg which is easily achieved through a balanced diet. Foods rich in vitamin C include bell peppers, citrus fruits, broccoli, Brussels sprouts and berries. Fresh and frozen are equally as nutritious. While vitamin C supplementation up to 1000mg/day won’t do you any harm, excess consumption can result in stomach pain and diarrhoea.

4

Vitamin D works with calcium and phosphorus for healthy bones, muscles and teeth. Vitamin D also helps to regulate our immune responses and a recent review of the research found that vitamin D supplements can help protect against acute respiratory infections, particularly among people who are deficient.

This is one vitamin where supplementation is recommended, although we can make vitamin D in the skin through direct sunlight, in Ireland the sunlight isn’t strong enough between March and October. We can get some vitamin D from diet as it is found in foods such as eggs, salmon and fortified milk but typically we don’t consume enough of these foods to meet our needs. Taking a 10 micrograms per day supplement is recommended for adults and children over the age of one year. With the social isolation precautions our time outdoors may be restricted a bit more and so supplementation is more important than ever.

5

Zinc helps the immune system to work properly and plays a role in wound healing. The immune system works well when we consume the recommended daily allowance of zinc which is 10mg / day. It is rare to be deficient in zinc as it is present in a wide range of foods including; lean meat, poultry, seafood, milk, whole grain products, fortified breakfast cereals, beans, seeds and nuts.

6

Selenium is involved in the normal function of the immune system. Good sources include Brazil nuts (5-6 Brazil nuts provide an adults daily needs) fish and seafood, brown rice, baked beans, sunflower seeds and oats are also good sources.

7

Most importantly, please remember that correct and frequent hand washing is your first line of defense and to continue to physically distance yourself as much as possible to break the chain of transmission. For more information check out the HSE website.

Aerobic Workout at Home

Aerobic Exercise

Exercises to get your heart rate rising!

Here is a video of a sample aerobic exercise session that includes a warm up, main phase and cool down.

Aerobic exercise describes any exercise that uses your arms and legs for a continuous period of time such as walking, cycling, swimming or a cardio exercise class. Aerobic exercise strengthens our heart and lungs. This type of exercise has consistently been shown to positively affect our cardiovascular health; improving blood pressure, blood sugar control, cholesterol levels and body weight. It is also associated with a whole host of other health benefits including a significant reduction in the risk of bowel and breast cancer.

In order to avail of these health outcomes it is important that you adhere to what we refer to in exercise as the FITT guidelines:

Frequency (How many days per week do I need to engage in this type of exercise)

      • 5-7 days/week

Intensity (How hard do I need to be working when I’m exercising)

      • Moderate

Time (How long should I exercise for)

      • 30-60 minutes per session. This is a target. If you are currently inactive, begin with 10 minutes and build up.

Type (Examples of aerobic exercise)

      • Regular, purposeful exercise that involves major muscle groups and is continuous and rhythmic in nature (i.e. walking, cycling).

These guidelines tell you how many days a week you should be doing aerobic exercise and also how long each aerobic session should last. Most importantly the guidelines state that your aerobic exercise should be of a moderate intensity. A rule of thumb is that you can say a sentence but perhaps not engage in a full conversation when you are completing your aerobic exercise.

The 30-60 minutes duration of an aerobic session does not include a warm up and cool down. These are important components of your aerobic exercise session. You should start slow and gradually build up the intensity of the warm up phase to ensure your heart and muscles are fully prepared for the main conditioning phase (moderate intensity). Similarly, it is very important to cool down after the conditioning phase. This involves gradually reducing the intensity of your efforts until your breathing and heart rate are almost at a pre-exercise level. See the above diagram for guidance on timings and intensities for a full aerobic exercise session.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

Stretch at Home

Stretching

Increase your flexibility and range of motion

As well as requiring our muscles to be strong, we also need them to be supple and stretchy. Supple muscles are less likely to become injured and more likely to facilitate easier execution of activities of daily living such as bending, reaching, lifting and turning.

This is a much neglected type of exercise largely due to peoples’ perceptions that it does not do much. Yet it holds the key to enhancing our aerobic fitness and muscle strength as well as being a standalone type of exercise with its own unique set of physical outcomes listed above. Stretching exercises can help address any muscle imbalances that can occur over the years from poor posture or other bad habits such as excessive sedentary behaviour. This in turn optimises our efforts in the other two types of exercise  (Aerobic & Resistance).

For effective muscle stretching please follow the FITT guidelines below.

Frequency (How many days per week do I need to engage in stretching)

    • ≥2-3 days a week

Intensity (How hard do I need to be working when I’m stretching)

    • Stretch to the point of feeling tightness or slight discomfort

Time (How long should I hold each stretch for)

    • 10-30 seconds. For older adults (>65 years of age) holding a stretch for 30-60 seconds can give greater benefits

Type (Examples of stretching exercises)

    • Watch the video for a complete series of muscle stretching exercises for each of the major muscle groups.

To avoid injury, it is important that you do these stretches when your muscles are warm (i.e. at the end of an aerobic or muscle strengthening session). See pg. 7 of our Resistance Training at Home booklet for cool down stretches.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

Resistance Training at Home

Exercises to help gain muscle strength

To begin strengthening your muscles you need to engage in resistance training. This involves performing a series of exercises where you lift a weight that you are unaccustomed to for a specific amount of repetitions. This type of training can provide significant functional benefits and improvements in overall health and well-being. These improvements include: increased bone density, improved muscle mass and joint function, reduced potential for injury, increased metabolism and improved cardiac function.

As with aerobic exercise there is a set FITT guideline to bring about the above physical outcomes.

Frequency (How many days per week do I need to engage in muscle strengthening exercise)

    • 2-3 days/week

Intensity (How hard do I need to be working when I’m doing my muscle strengthening exercise)

    • Moderate* intensity

Time (How long should a muscle strengthening session last for)

    • Approx. 30-40 minutes – complete 8-10 exercises per set and aim to complete 2-4 sets.

Type (Examples of muscle strengthening exercise)

*It is important that you perform your muscle strengthening exercises at a moderate intensity. In this instance, moderate intensity refers to the amount of times you can lift a weight during an exercise. Ideally you want to select a weight for each exercise that you can lift 12 times. If you can easily perform 15 repetitions of an exercise, the weight is low intensity and not enough of a challenge to strengthen your muscles. Likewise if you struggle to perform 8 repetitions, the weight is high intensity and not appropriate.  You can download our Resistance Training at home booklet which will explain this is a little more detail.

 

Please read page 8 of our Resistance Training at Home booklet for important general instructions for resistance training at home.

Need some help or have a question?

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

See more home workout videos below!

FAQs: COVID-19 and Cardiovascular Disease

FAQ

Here are some of the frequently asked questions that our Croí team have covered this week in relation to COVID-19. We will keep this page updated regularly. The Croí Health Team are following National & International best practice guidelines and the advice of the HSE. Learn more at www.hse.ie.

1. Why are older adults and people with chronic health conditions at higher risk of more serious illness if they catch coronavirus COVID-19?

As we age our immune systems grow weaker, which makes it more challenging for older adults to fight off infectious diseases.  Chronic health conditions are more common as we get older. These conditions like heart disease, stroke, lung disease, diabetes, cancer or high blood pressure might mean your immune system isn’t as strong as others when exposed to viruses.

If you have a heart condition the virus could affect your heart in several ways. It is mainly associated with the lungs but if your diseased heart has to work harder to get oxygenated blood throughout the body, it may cause an extra strain. This can worsen problems for people with heart failure, where the heart is already struggling to pump blood efficiently.

2. I’ve heard that high blood pressure or my blood pressure medications could cause more severe Covid-19 infection – should I stop taking my blood pressure tablets?

It is always important to take any heart medication your doctor has prescribed, and even more so when you are at risk of being exposed to the COVID-19 virus. By taking your medication, you can better protect your heart, which can help protect you against complications of COVID-19 if you do get it.

It has been suggested, especially on social media sites, that commonly used medications (see list below) used to treat high blood pressure and certain heart conditions may increase the risk of infection and the severity of COVID-19. Because of this, patients taking these drugs for their high blood pressure and their doctors have become increasingly concerned, and, in some cases, have stopped taking their medications.

It is important to highlight that this information is speculation and does not have a sound scientific basis or evidence to support it. Best practice guidelines from the European Society of Cardiology Council on Hypertension strongly recommend that physicians and patients should continue treatment with their usual anti-hypertensive therapy.

Blood pressure medications:

  • Angiotensin converting enzyme inhibitors (ACE-i)
    • common examples include Capoten (captopril), Tritace (ramapril), Coversyl (perindopril), Vasotec (enalapril) Prinivil, Zestril (lisinopril) Lotensin (benazepril)
  • Angiotensin Receptor Blockers (ARBs)
    • common examples include Atacand (candesartan), Teveten (eprosartan), Micardis (telmisartan), Diovan (valsartan), Cozaar (losartan), Benicar (olmesartan)

3. I have a chronic heart condition… What can I do to reduce my risk?

For heart and stroke patients, prevention is key. If you are in an at-risk group or caring for someone in an at-risk group, you should follow the HSE general advice on how to protect yourself from coronavirus.

Cocooning is now recommended for all individuals aged 70 and over or those who have underlying medical conditions, visit the cocooning section of our website to see if you fall into this category. If you are not advised to cocoon you should still stay at home as much as possible, only leaving the house when needed such as to attend medical appointments or for food shopping. For further information, see our COVID-19 advice page. In addition to the general advice, do your best to keep your condition well-controlled. That means:

  • Follow your doctor’s advice including taking medications as directed.
  • If possible, get a 90-day supply of your prescription medications so you don’t have to go regularly to the pharmacy to pick them up.
  • Have a plan for if you do get sick
    • Watch your health for new symptoms
    • Stay in touch with family, friends, neighbours as you may need to ask for help if you become sick
    • Have a backup plan for who can care for you if your caregiver gets sick
  • If you are family/caregiver
    • Know what medications are prescribed and make sure supplies are on hand
    • Have a backup plan to make sure food and other supplies needed are available
    • Determine who can take over if you become sick

Looking after your emotional health & well-being

2

It is normal to feel concerned about COVID-19. Being asked to avoid and reduce human contact, to socially distance ourselves and to self-isolate goes against human nature. It is the opposite of what humans want to do in a crisis. This can affect your mental and physical health. However, there are many things you can do to mind your mental health and it is important to stay positive and focus on what can you do rather than what you cannot.

Firstly, being aware of your own emotions addressing how you think and feel, will help you in coping. Over the coming days, weeks and months people’s lives will change, but it is important to keep things in perspective as this will pass.

You may notice feeling

  • increased anxiety
  • feeling stressed
  • finding yourself excessively checking for symptoms, in yourself, or others
  • becoming irritable more easily
  • feeling insecure or unsettled
  • fearing that normal aches and pains might be the virus
  • having trouble sleeping
  • feeling helpless or a lack of control
  • having irrational thoughts

People with cardiovascular disease

People who have cardiovascular disease or who have experienced a stroke may be more likely to experience anxiety or stress in relation to the outbreak of COVID-19 virus. There are many reasons for this, such as the fact that you are in the at risk group for COVID-19 virus. You are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications. 

Although the link between stress and the risk of heart disease and stroke is not well understood, we do know that stress can increase your blood pressure, impact on the blood clotting mechanism and result in people leading an unhealthy lifestyle. For example as a coping mechanism people are more likely to increase their caffeine intake, smoke, drink more alcohol and be less active when they are stressed.

If you have heart disease, being anxious or stressed may bring on symptoms like angina (chest pains).  If you do experience chest pains, please do not delay in calling 999 or 112. The emergency departments are still open for business as are all hospitals.

It isn’t possible to avoid stress completely but we can change the way we cope with it, particularly with of the outbreak of COVID-19 and the imposed control measures. 

Our top 5 recommendations for reducing stress and anxiety:

4

1. Stay connected

Social support is proven to be an important factor in protecting our mental health against negative feelings. Stay in touch with friends and family using mobile technology such as WhatsApp, Skype and video calls. Telephone, text and email. Check in on elderly and vulnerable neighbours. Remember you don’t have to appear strong and try to cope with things on your own. Speaking to others and talking things through can reduce anxiety and worry.

6

2. Limit your exposure to media

The constant stream of updates and news about COVID-19 can be overwhelming and cause increased anxiety. It can be difficult to separate facts from fiction. Use only trustworthy and reliable sources such the HSE and the Department of Health. Try to limit social media usage, set yourself times during the day to check for updates. If you are finding the COVID-19 coverage upsetting or too intense talk it through with a friend or family member. Remember much of the information online is driven by people’s personal opinion’s, beliefs and agendas and it may not be helpful for you to take these on as your own right now.

8

3. Get a good night’s sleep

Sleep is closely linked to our mood and mental health, sleep disruption and poor quality sleep can negatively impact on your mood. Try to maintain regular sleep patterns it can be unhealthy to fall into bad habits such as going to bed later and getting up later. Changes to your sleep pattern now could impact on your mood in the weeks, months ahead. Try to maintain a routine scheduling daily activities throughout the day such as exercise and relaxing activities. If worrying feelings or thoughts are preventing you from achieving good quality sleep, try talking them through with someone.

10

4. Maintain a healthy routine

Your normal daily routine may be affected by COVID-19, but trying to keep some structure will help. Pay attention to your needs and feelings during this time especially during times of stress. You may still be able to do some of the things you enjoy and find relaxing. For example this may include regular exercise, practicing relaxation techniques or reading a book. Try Chair Yoga with our incredible instructor, Vicky Harkin!

12

5. Practice self-care

In times like this with the outbreak of COVID-19 we have a responsibility to ourselves to practice self-care. If we don’t practice self-care we will be of less use to ourselves and to others. Examples of self-care include:

  • cooking healthy nourishing meals
  • allowing yourself time to engage in the things you enjoy
  • taking time to relax
  • setting boundaries – such as saying no to visitors and reducing demands on yourself to prevent burn out
  • Practice mindfulness, meditation, walking or baking- small changes that you will be able to continue with post COVID-19

Try to keep things in perspective, things will get better.

Heart Healthy Greek Yogurt Bowl

Recipe from Croí Dietitian, Meabh Durkin

As many of us adjust to working from home, the reduced commute time does not translate into additional morning leisure time for most! It can be challenging at first to establish your new routine over the coming weeks but let’s start the day with our best foot forward and what better way than with a very simple, heart healthy breakfast.

Greek yogurt bowls make for a delicious and satisfying breakfast. The variations are endless and by using some key ingredients shown below we can create a low calorie, high protein and high fibre breakfast.

Heart Healthy Greek Yogurt Bowl Recipe

Ingredients:

  • 40g frozen raspberries
  • 200g 0% Greek yogurt
  • 1 tsp. (5g) whole chia seeds
  • 10-12 almonds
  • 1 heaped dsrt. sp. (~10g) crunchy oat cereal.

Method:

  1. Simply heat the raspberries in the microwave for 40 seconds.
  2. Add the yogurt to a bowl and top with the berries and remaining ingredients!

Key Ingredients:

 0% Greek yogurt:
Fat-free or low-fat Greek yogurt gives you the best bang for your buck as it’s low in calories while being high in protein. It also has a thick, creamy texture. You can use plain, natural or dairy free yogurts, however most flavoured yogurts are high in additional sugars. Looking at the nutritional panel on the carton, a low-fat yogurt is one that contains less than 3g of fat per 100g and a low-sugar yogurt (including both added and sugar naturally present in milk from lactose) is less than or equal to 5g (for natural yogurts) and 9g (for flavoured yogurts).

Frozen fruit:
Of course you can also use fresh fruit if you have it, however frozen fruit is a great staple to have in your freezer and often results in less waste. Raspberries or blueberries are a great low-sugar option. You can defrost them in the microwave and add them to the bowl warm.

Nuts and seeds:
Chia seeds and whole almonds are used in this recipe but flax, linseed, hemp, cashews, hazelnuts or walnuts are equally as good options. Nuts and seeds are loaded with heart healthy fats and low in saturated fat while also providing fibre which helps regulate blood sugar levels as well as reducing bad cholesterol levels, therefore improving heart health. They are also a great source of the antioxidant vitamin E and minerals such as zinc and magnesium. 100% peanut or almond butter is also a lovely alternative. Remember nuts are high in calories with a recommended serving of nuts being 40g.

Additional extras:
This recipe has a small amount of cereal added for some extra crunch. A high fibre bran, low sugar muesli or oats could also be added. However be mindful of your additional extras so they don’t add up to unnecessary added sugar and calories! Unsweetened desiccated coconut, cinnamon or a drop of vanilla essence make for great low calorie add-ons.

As a general guide, healthier breakfast cereals should contain no greater than 6g of sugar, 3g or less of fat and should have a fibre content of 3g or more per serving (usual serving of breakfast cereals is 30-40g).

Greek Yogurt Bowl

Mixed Veg & Chickpea Curry

Recipe from Croí Lead Dietitian, Suzanne Seery

This is a really quick and easy to prepare recipe. It can be made using long life store cupboard foods such as tinned and frozen vegetables, which are usually a bit cheaper when cooking on a budget.

Dietitian’s Tip:

This is a heart healthy dish as it is low in calories, high in fibre and because the chickpeas are a plant based protein, it is very low in saturated fat.

Serves: 4 people
Prep time: 35 minutes
Typical nutrition value per portion (approx.):
Energy: 200kcal, 35grams of carbohydrate, 13 grams of protein, 1.5grams of fat, (0.5g saturated fat) and 9g of fibre.

Chickpea

Ingredients:

  • 2 teaspoons vegetable oil
  • 1 cup chopped onion
  • 3 garlic cloves, finely chopped
  • 1⁄2 teaspoons curry powder
  • 1 teaspoon ground cumin
  • Black pepper to season
  • About 5 handfuls/cups of mixed frozen vegetables (e.g. carrots, broccoli, cauliflower, peas)
  • 1⁄2 cup water
  • 1 tin of chopped tomatoes
  • 1 tin chickpeas, rinsed and drained

 

Recipe:

  • Heat oil in a large, non-stick pan over medium heat. Add onion and garlic.
  • Sprinkle with curry powder, cumin, and black pepper. Cook for 3 minutes, stirring frequently and adding small amounts of water as necessary, about a tablespoon at a time, to prevent sticking.
  • Add the frozen mixed vegetables and water to the pan. When water boils, reduce heat to medium-low, cover pan and simmer 5 minutes or until vegetables are cooked but still have a bite.
  • Add remaining ingredients, mixing well. Cover and simmer 15 minutes.
  • Serve with wholemeal brown rice, 1 x 200ml cup of cooked rice is equal to one serving of carbohydrates rich foods from the food pyramid.

Stroke of Genius

Introducing our new series, “Stroke of Genius”.

We value people’s lived-experience as well as professional input and consider it all part of the education and support for people who have had a stroke. Croí’s support groups for stroke survivors and their families are a source of great learning and we want to share this in our new series, “Stroke of Genius”.

Kudos to our Mayo members for the great name suggestion!

The Croí Stroke Support Group meet at Croí House on the second Thursday of every month and new members are always warmly welcomed. Please call Jessica on 091 544310 for further information.

Giving up Smoking – Pádraic’s Story

Quitting smoking is the single best thing you could do for your health, but breaking the smoking habit is not easy and takes time. We spoke with Croí Programme Participant Pádraic Ó Corrduibh from Lochan Beag, Inverin, who shared his story on giving up smoking for good.

National No Smoking Day takes place on Ash Wednesday, which falls this year on February 26th. If you are a smoker, you can sign up to a quit plan here.