COVID-19 Salgını: Diyetisyenlerin Rolü ve Rehberler

Diyetisyenler klinik beslenme uzmanlarıdır ve sağlıklı, akut ve kronik hastalığı olan bireylerin, yaşlıların, farklı durumlarda risk altındaki toplum gruplarının beslenme gereksinimlerini desteklemek, beslenme durumlarını saptamak ve izlemek üzere özel eğitim almış tek meslek profesyonelidir. COVID-19 salgın sürecinde de diyetisyenlerin öncelikle bireylerin ve toplum gruplarının bağışıklık sisteminin güçlendirilmesi ve evde karantina sürecinde optimal beslenmenin desteklenmesi, hastanede yoğun bakım ünitelerinde hastaların beslenmesinin yönetiminde önemli rolü bulunmaktadır. Diyetisyenlerin COVID-19 salgını sürecinde beslenmenin yönetiminde kullanabileceği yayınlanmış rehberler bulunmaktadır.

COVID-19 Pandemic: Role of Dietitians and Guidelines

Dietitians are the clinical nutrition experts and are the only professionals specifically trained to support the nutrition needs of healthy, acutely and chronically ill people with a wide range of conditions, to support and monitor the nutritional status of populations at risk, including older adults. The core role that dietitians are playing during the COVID-19 pandemic, from the frontline in promoting optimal nutrition for supporting the immune system of the subjects and population groups and the quarantine period at home, management of nutrition in intensive care unit patients. Published guidelines are available for the dietitians to be used during the COVID-19 pandemic.

PDF

___

1. Lipsitch M, Swerdlow DL, Finelli L. Defining the epidemiology of Covid-19: Studies needed. N Engl J Med. 2020;382:1194-6.
2. World Health Organization (WHO) Coronavirus (COVID-19). April, 2020. Available at: https://covid19. who.int/ region/euro/country/es Accessed April 28, 2020.
3. Muscogiuri G, Barrea L, Savastano S, Colao A. Nutritional recommendations for CoVID-19 quarantine. Eur J Clin Nutr. 2020;74:850-1.
4. Rodríguez-Martín BC, Meule A. Food craving: new contributions on its assessment, moderators, and consequences. Front Psychol. 2015;6:21.
5. Barazzoni R, Bischoff SC, Breda J, Pirlich M, Singer P, endorsed by the ESPEN Council. ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020;39(6):1631-8.
6. Handu D, Moloney L, Rozga M, Cheng FW. Malnutrition care during the COVID-19 pandemic: Considerations for registered dietitian nutritionists. J Acad Nutr Diet. 2020;2:1.
7. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med. 2020;180(7):1-11.
8. Wu D, Wu T, Liu Q, Yang Z. The SARS- CoV-2 outbreak: what we know. Int J Infect Dis. 2020;94:44–8.
9. Calder PC. Nutrition, immunity and COVID-19. BMJ Nutrition, Prevention & Health. 2020;0.
10. Maggini S, Pierre A, Philip C. Calder PC. Immune function and micronutrient requirements change over the life course. Nutrients. 2018;10(10):1531.
11. Cardenas D. Let not thy food be confused with thy medicine: the Hippocratic misquotation. e-SPEN J. 2013;8:e260–e262.
12. Witkamp RF, van Norren K. Let thy food be thy medicine…. when possible. Eur J Pharmacol. 2018;836:102-14.
13. Alpert P. The role of vitamins and minerals on the immune system. Home Health Care Manag Pract. 2017;29:199-202.
14. Calder P. Conference on ‘Transforming the nutrition landscape in Africa’. Plenary Session 1: Feeding the immune system. Proc Nutr Soc. 2013;72:299-309.
15. Bhaskaram P. Micronutrient malnutrition, infection, and immunity: An overview. Nutr Rev. 2002;60:40–5.
16. European Federation of Associations of Dietitians (EFAD). European Academic Standards for Dietetics EFAD; 2018. http://www.efad.org/media/1633/efadacademic-standards-revised-june-2018.pdf Accessed June 2020.
17. European Federation of Associations of Dietitians (EFAD). European Dietetic Advanced Competences (EFAD). 2016. Available at: http://www.efad.org/ media/1419/european-dietetic-advanced-competences. pdf Accessed July, 2020.
18. European Federation of Associations of Dietitians (EFAD). Dietitians in Europe Definition, Profession and Education Statement by the European Federation of the Associations of Dietitians (EFAD). September 2016. Available at: http://www.efad.org/media/1417/revised-definition-of-a-dietitian.pdf Accessed July, 2020.
19. European Federation of Associations of Dietitians (EFAD). European Dietetic Advanced Competences (EFAD). July, 2012. Available at: http://www.efad.org/ media/1419/european-dietetic-advanced-competences. pdf Accessed July 2020.
20. European Federation of Associations of Dietitians (EFAD). International Code of Ethics and Code of Good Practice. September, 2008. Available at: http://www. efad.org/media/1420/international-code-of-ethics-and-code-of-good-practice.pdf Accessed July, 2020.
21. International Confederation of Dietetic Associations (ICDA). International Standards for Dietitians Nutritionists http://www.internationaldietetics.org/ International-Standards/International-Definition-of-Dietitian.aspx) Accessed June 2020.
22. European Federation of Associations of Dietitians (EFAD). The implementation of a Nutrition Care Process (NCP) and Standardized Language (SL) among dietitians in Europe. EFAD 2014.
23. Huang Z, Liu Y, Qi G, Brand D, Zheng SG. Role of vitamin A in the immune system. J Clin Med. 2018;7:258.
24. Carr A, Maggini S. Vitamin C and immune function. Nutrients. 2017;9:1211.
25. Gois P, Ferreira D, Olenski S, Seguro AC. Vitamin D and infectious diseases: simple bystander or contributing factor? Nutrients. 2017;9:651.
26. Chirumbolo S, Bjørklund G, Sboarina A, Vella A. The role of vitamin D in the immune system as a pro- survival molecule. Clin Ther. 2017;39:894–916.
27. Kohlmeier M. Avoidance of vitamin D deficiency to slow the COVID-19 pandemic. BMJ Nutrition, Prevention & Health. 2020;0.
28. Lee G, Han S. The role of vitamin E in immunity. Nutrients .2018;10(11):1614.
29. Gammoh NZ, Rink L. Zinc in infection and inflammation. Nutrients. 2017;9:624.
30. Avery J, Hoffmann P. Selenium, selenoproteins, and immunity. Nutrients 2018;10:1203.
31. Huang Z, Rose AH, Hoffmann PR. The role of selenium in inflammation and immunity: from molecular mechanisms to therapeutic opportunities. Antioxid Redox Signal. 2012;16:705–43.
32. Casas R, Sacanella E, Estruch R. The immune protective effect of the Mediterranean diet against chronic low grade inflammatory diseases. Endocr Metab Immune Disord Drug Targets. 2014;14:245-54.
33. Mazzocchi A, Leone L, Carlo Agostoni C, Pali-Schöll I. The secrets of the Mediterranean Diet. Does [Only] olive oil matter? Nutrients. 2019;11(12):2941.
34. Iddir M, Brito A, Dingeo G, Del Campo SSF, Samouda H, Michael R, et al. Strengthening the immune system and reducing ınflammation and oxidative stress through diet and nutrition: considerations during the COVID-19 Crisis. Nutrients. 2020;12:1562.
35. McAuliffe S, Ray S, Fallon E, Bradfield J, Eden T, Kohlmeier M. Dietary micronutrients in the wake of COVID-19: an appraisal of evidence with a focus on high- risk groups and preventative healthcare. BMJ Nutrition, Prevention & Health. 2020;0.
36. Zabetakis I, Lordan R, Norton C, Tsoupras A. COVID-19: The inflammation link and the role of nutrition in potential mitigation. Nutrients. 2020;12:1466.
37. Verma M, Hontecillas R, Abedi V, Leber A, Tubau-Juni N, Philipson C, et al. Modeling-Enabled systems nutritional immunology. Front. Nutr. 2016;3:5.
38. Pawelec G, Larbi A, Derhovanessian E. Senescence of the human immune system. J Comp Pathol. 2010;142:39–44.
39. Pera A, Campos C, López N, Hassouneh F, Alonso C, Tarazona R, et al. Immunosenescence: implications for response to infection and vaccination in older people. Maturitas. 2015;82:50–5.
40. Agarwal S, Busse PJ. Innate and adaptive immunosenescence. Ann Allergy Asthma Immunol. 2010;104:183-90.
41. Montgomery RR, Shaw AC. Paradoxical changes in innate immunity in aging: recent progress and new directions. J Leukoc Biol. 2015;98:937–43.
42. Ventura MT, Casciaro M, Gangemi S, Buquicchio R. Immunosenescence in aging: between immune cells depletion and cytokines up- regulation. Clin Mol Allergy. 2017;15:21.
43. Moynihan AB, van Tilburg WA, Igou ER, Wisman A, Donnelly AE, Mulcaire JB. Eaten up by boredom: consuming food to escape awareness of the bored self. Front Psychol. 2015;6:369.
44. European Federation of the Association of Dietitians (EFAD). Covid-19 Information on Nutritional Support. 2020. Available at: http://www.efad.org/en-us/covid-19/ Accessed July 15, 2020.
45. World Health Organization (WHO) Food and Nutrition Tips during Self-Quarantine. 2020. Available at: http://www.euro.who.int/en/health-topics/ health-emergencies/coronavirus-covid-19/novel-coronavirus2019-ncov-technical-guidance/food-and-nutrition-tips-during-self-quarantine Accessed April 15, 2020.
46. Barrea L, Muscogiuri G, Frias-Toral E, Laudisio D, Pugliese G, Castellucci B, et al. Nutrition and immune system: from the Mediterranean diet to dietary supplementary through the microbiota. Critical Reviews in Food Science and Nutrition. 2020:1-25.
47. Childs CE, Calder PC, Miles EA. Diet and immune function. Nutrients. 2019;11(8):1933.
48. Rinninella E, Cintoni M, Raoul P, Lopetuso LR, Scaldaferri F, Pulcini G, et al. Food components and dietary habits: keys for a healthy gut microbiota composition. Nutrients. 2019;11(10):2393.
49. Public Health England. Excess Weight and COVID-19. Insights from new evidence. UK, 2020.
50. Rodríguez-Pérez C, Molina-Montes E, Verardo V, Artacho R, García-Villanova B, Guerra-Hernández EJ, et al. Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet Study. Nutrients. 2020;12(6):1730.
51. Di Renzo L, Gualtieri P, Pivari F, Soldati L, Attinà A, Cinelli G, et al. Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey. J Transl Med. 2020;18:229.
52. Food and Agriculture Organization of the United Nations (FAO). Food safety in the time of COVID-19. Rome. April 14, 2020. Available at: http://www.fao.org/3/ca8623en/ CA8623EN.pdf Accessed June 10, 2020.
53. T.C. Sağlık Bakanlığı. Türkiye Beslenme Rehberi (TÜBER). Sağlık Bakanlığı Yayınları, Ankara, 2015. 36 s.
54. Cena H, Maffoni S, Braschi V, Brazzo S, Pallavicini C, Vietti I, et al. Position paper of the Italian association of medical specialists in dietetics and clinical nutrition (ANSISA) on nutritional management of patients with COVID-19 disease. Med J Nutrition Metab. 2020;13(2):113- 7.
55. British Dietetic Association. COVID-19 / Coronavirus Clinical Guidance. 2020. Available at: https://www.bda. uk.com/practice-and-education/covid-19-coronavirus-clinical-guidance.html Accessed June, 2020.
56. British Dietetic Association. Critical Care Specialist Group. 2020. https://www.bda.uk.com/uploads/ assets/59fe265f-49df-4c0f-9ffe78993f20a26b/de96258a2857-4bbe-90654cc7fc8f80d5/Nutrition-in-hospital-after-critical-illness-FINAL-PDF-Version-June2020.pdf ve https://www.bda.uk.com/uploads/assets/f5215258- 7a34-4426-83620ba89f87c638/b4ec8d2c-156e-4e30- a8920619ca6e3a4d/CCSG-Guidance-for-COVID-19- Formatted.pdf
57. British Dietetic Association. COVID-19 / Coronavirus Advise for dietitians. 2020. Available at: https://www. bda.uk.com/resource/covid-19-coronavirus.html Accessed June, 2020.
58. Hungarian Dietetic Association. Infographics for the general public. CoronaVirus Nutrition Guide 1, 2 and 3. 2020. Available at: http://www.efad.org/en-us/covid-19/1- public-health-nutrition-advice-for-the-coronavirus-pandemic/ Accessed June, 2020.
59. General Council of Dietitians-Nutritionists and the Spanish Academy of Nutrition and Dietetics. Food and nutritional recommendations for COVID-19 critically ill patients admitted to the ICU. http://www.efad.org/ en-us/covid-19/1-public-health-nutrition-advice-for-the-coronavirus-pandemic/
60. Elisabet R. GLIM criteria for the diagnosis of malnutrition – An important tool for the dietetic profession. J Clin Nutr Diet. 2020;6(1):2.
61. Cederholm T, Jensen GL, Correia MITD, Gonzalez MC, Fukushima R, Higashiguchi T, et al. GLIM Core Leadership Committee; GLIM Working Group. GLIM criteria for the diagnosis of malnutrition - A consensus report from the global clinical nutrition community. Clin Nutr. 2019;38(1):1-9.
62. Keller H, Van der Schueren MAE, Jensen GL, Barazzoni R, Compher C, et al. Global Leadership Initiative on Malnutrition (GLIM): Guidance on validation of the operational criteria for the diagnosis of protein-energy malnutrition in adults. JPEN J Parenter Enteral Nutr. 2020;44(6):992-1003.