Coronavirus in Context: Dietitian Shares Tips to Maintain Strong Immunity

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Hello. I'm Dr. John Whyte, Chief Medical Officer at WebMD. And welcome to "Coronavirus in Context." Today we're going to talk about the role of nutrition in the coronavirus epidemic. And I'm delighted to be joined by Dr. Beth Kitchin. She is an assistant professor and registered dietitian at the University of Alabama at Birmingham.

Thanks for joining me, Dr. Kitchin.

Thank you for having me.

And I love the name.

Oh, yes.

In the kitchen -- I'm sure you've heard that.

Thank goodness it is my real name. It's my born with name, yes.

So let's start off with if we think that food is medicine, and we know that some foods might help with immunity, what should be on our grocery list?

Well, one of the things that I really want to point out is that nutrition is not going to protect you from the coronavirus. So you know it's really important to listen to the experts who are telling you to wash your hands, keep that distance from people. Those are really the most important things. So I really, really want to stress that.

Now, of course, nutrition does play a role in immunity. But that does not mean that you should go out and start popping pills. Because one of the things that's really important to understand is that you'll hear a lot of people saying, we need to boost immunity. Well, you can actually over-boost immunity, for one thing. And so that really shouldn't be your goal. Your goal should be to maintain a strong immunity.

One of the things that can really help with that is something as simple as getting enough sleep, getting enough rest. That can be really problematic for a lot of us at this time, because we have some anxiety. We have some worries. So we have to deal with that. So even though we may have more time to sleep, it may be a little bit harder.

What about key foods? Are there some key foods, though, that you'd recommend?

There are. I really recommend focusing on fruits and vegetables. Focusing on fruits and vegetables are going to give you things like Vitamin C. We know that when we get enough Vitamin C we do support immunity. When you're getting all those really important phytochemicals that you get from fruits and vegetables.

Does it matter if they're frozen or canned? Because the fresh may spoil.

That's such a good -- that is such a good question, because I'm trying to limit my grocery store time to once a week. I'm running out of my fresh fruits and vegetables. And so what I recommend is first of all frozen. Frozen have just as much of those really key nutrients as fresh. Sometimes they have even more, because when they flash freeze those, they are often at a point of freshness and maximal nutrient content.

Think about our fresh fruits and vegetables -- they have to travel sometimes, and so they might lose some of those nutrients. They sit-in our refrigerators, and so they may be losing some of those. So frozen are really excellent. And even canned still maintain quite a bit of their nutrient status. And in fact, some nutrients like beta carotene -- you've heard of beta carotene, a very important antioxidant.

Where do we get it? Where do we get that beta carotene?

We get that from our deep orange fruits and vegetables, things like carrots, cantaloupe. Spinach, even though it's green, is actually quite high in beta carotene. The predominant color that you have in spinach is chlorophyll, so that kind of masks it. But those are all really high in beta carotene.

And we actually are able to use the beta carotene. It's more available to our bodies actually when it's been cooked. So canned fruits and vegetables are actually sources of more available beta carotene to us.

What else is on your grocery list?

Well for me, like many people I've been eating a lot of eggs. I've been eating a lot of asparagus. I've been looking at those kind of sturdy fruits and vegetables. I've been buying things like potatoes and onions. And I'm drinking orange juice and all of these things that last quite a long time that I know are going to maintain their nutrient status and give me that protein. We haven't talked about protein yet. That's another really important nutrient to maintain your health, your immunity.

Is it OK to have those comfort foods now? You talked a little bit about stress. Do we need to be doing better now, or can we say, you know, what? It's OK to loosen up.

I'm a big fan of comfort foods all the time, especially in times like this. This is not a time for us to be going on some rigid diet and punishing ourselves. We deserve a little slack. So if macaroni and cheese is your favorite, I know I've bought some things that I typically don't buy like goldfish crackers and some cookies that I typically don't have. I'm like, oh I kind of need --

That's OK now.

Yeah. It's actually always OK, of course, in moderate amounts. But you know, we also don't want to gain weight. We're at a time when you're at home, you might be bored. It's really easy to run into the kitchen and snack a lot. So I always recommend have those comfort foods, the chocolate -- it's Easter time coming up for a lot of us, so you know chocolate is important as well.

But what I really recommend people do is portion it out. Take it to the table, the couch, the porch, wherever you're going to go have that snack. Don't stand in the kitchen with the bag of chips open or the box of cookies open.

So still buy them, but maybe just not five bags of chips.

Exactly. So read your portion sizes, use that food label. The new food labels are great.

Do we involve our kids in meal plans? Is that a good idea?

I think it's really important at this time to make sure that you are planning out meals. Maybe not necessarily what you're going to eat -- I don't ever know what I'm going to want for dinner. Some people like to plan out their whole day and that can be a good idea. But do plan to eat at particular times. Keep that breakfast, that lunch, that dinner, maybe a snack in the afternoon. And what that does is, first of all, it gives your day structure. But what it also does is it keeps you from getting hungry, and that's the worst for things like cravings, overeating, binging. If you let yourself get hungry, that's when you really get into trouble.

Are a handful of nuts good for that? Oh, that's one of the things that I've been doing quite a bit. I have a big bag of pistachios that my mother gave me for Christmas. A huge bag. And so I've been snacking on that. And what I do is I put some in a bowl, I put some peanuts in with it. Put a few goldfish crackers in it so I get my goldfish crackers in there. But I make like a little kind of mini trail mix, and that's really satisfying. It's giving me a lot of really important nutrients. And again, very satisfying. And that's been sort of my go to afternoon snack.

What about -- we've been hearing about Vitamin D and how it may impact immunity. There's a lot of chatter online. What's your thoughts about Vitamin D supplementation?

So I actually work in our osteoporosis patient education clinic -- our osteoporosis prevention and treatment clinic here at UAB. So we work a lot with Vitamin D supplementation. And for Vitamin D it's very hard to get enough Vitamin D from foods. Most of us are not able to make it from the sun, because we're using sunscreen. We're not out in the sun enough. And Vitamin D plays a role in bone health, but it also plays a role in immunity.

But I really want to stress that more is not better. If your Vitamin D levels are healthy, piling on more Vitamin D is not going to make your immunity stronger. However, if you're low in Vitamin D and you're not getting enough, then you might have a compromised immune system because of that. So I do recommend that most people get some Vitamin D supplementation. I do every day.

Now again, you don't want to overdo it and so that's important. Don't super supplement with that.

600 international units?

Yeah. What I recommend -- you know, we kind of base our recommendations on what our patient's blood levels are. Most people don't know their blood levels. So what I recommend is roughly about 1,000 units of Vitamin D every day from your over the counter supplements. So if you take a multivitamin, if you take a calcium supplement that has D in it. So it may not be that you need a Vitamin D supplement.

DR. JOHN WHYTE: And recommendations can vary between 600 to 1,200.

Exactly. Some of our patients, if they're low in Vitamin D, we actually go up to 2,000, 3,000, 4,000 a day for a short period.

That's a great point.

Right. And then when they get their levels where they're healthy, then we back them down. Because again, too much Vitamin D can actually be detrimental. And that's true of all nutrients. So just be very careful. If you want to take, for instance, a Vitamin C supplement. If you're thinking, well, maybe Vitamin C can help my immunity. I'm not going to tell you not to do that, but don't go over 1,000 milligrams a day. It can cause stomach cramping, diarrhea.

What about the zinc? People have been asking about zinc.

A lot of people are talking about zinc. And one of the things that we talk about with zinc is that in the form of zinc lozenges, it seems to stimulate the immune system. However, we know that with things like colds. And what we usually tell people to do with that is to take it right at the start of a cold, because these levels are very high. And if you overdo it for too long a period of time, again, you could get toxic levels of that.

We also know that zinc nose sprays can actually cause a permanent loss of smell. So again, be very careful with these supplements. Now getting enough zinc from foods, absolutely. And that's where your high protein foods kind of go along with zinc.

What are those examples? Tell us those.

Things like meat, seafood, tuna fish, things of that nature usually have good amounts of zinc in them.

And then real quickly on meal planning, you might have a lot of people in the house now that you otherwise might not have had. You're limited to being able to go to the grocery store. How do you manage some complex meal planning? Is it you get what you get and you don't get upset? Or do you try to please?

DR. BETH KITCHIN: Cook those bulk meals that you can make. I'm a big believer in pasta. Coming from an Italian American mother, you know, we eat a lot of pasta. We like to do these big beans and rice and pasta dishes that you could put in a big pot.

I have also been recommending to people that a great way to support the economy is to go out and do that curbside pickup takeout with various restaurants in your community. It's a great way to get some variety in your eating, get out of that cooking rut. I'm getting so tired of the same foods that I cook over and over again.

It's also a great time, though, to tune in to radio, TV, social media. A lot of people are talking about this. A lot of chefs are coming on and talking about all these great things that you can go to. I have a lot of really fun things that I do called cooking with cans, where I take a can of chopped tomatoes and maybe a can of clam sauce and mix those together and let it simmer, and it makes a wonderful pasta sauce. And so getting creative with things that you've got in your cabinet. You know, take some of those things like beans and rice and then flavor them up with some other things that you have around the house. And you might be surprised to discover some really neat dishes.

Great idea. Good time to experiment, and a great reminder to support our local restaurants. I want to thank you, Dr. Kitchin.

Thank you, I've enjoyed this.

And I want to thank you for watching "Coronavirus in Context." I'm Dr. John Whyte.