Diet has long been recognized as a significant factor in overall health, as well as an effective way to manage chronic conditions such as heart disease, diabetes, and kidney disease. Recently, professors Samuel J. White, Ph.D. and Philippe B. Wilson, Ph.D. of Nottingham Trent University, investigated several popular eating methods said to help manage Long COVID symptoms.*

The ‘anti-inflammatory diet’

Inflammation is the body’s immune response to harmful pathogens, damaged cells, irritants, and other potential dangers that either invade or grow inside the body. Research has shown that too much inflammation, experienced on an ongoing basis, can be harmful, however. In fact, it’s believed that chronic inflammation is at the root of many Long COViD symptoms, including lung and kidney damage, brain effects, and behavioral changes following SARS-CoV-2 infection.

It is known that fried foods; sugary items; refined carbohydrates, like pastries and white bread; red and processed meats; and lard can trigger inflammation. 

There are also foods that have anti-inflammatory effects from their antioxidant and other chemical components, such as foods found in the Mediterranean diet:

• Green leafy vegetables
• Olive oil
• Tomatoes
• Nuts
• Cold-water fatty fish
• Fruits like blueberries and strawberries

The authors suggest following the Mediterranean diet for its proven anti-inflammatory properties, including balancing the gut microbiome where chronic disease often begins. 

The ‘low-histamine diet’

Cells release histamine (a chemical from your immune system) in response to foreign allergens or proteins or after an injury. When histamine can’t be broken down properly, and levels rise too high, inflammation can occur. Since many of the resulting symptoms, like fatigue and headaches, overlap with Long COVID, investigators have suggested that increased histamine from dysfunctional immune cells could be at the root of Long COVID inflammation.

Histamine can also be present in food when certain bacteria react with food chemicals. In a low-histamine diet, foods high in histamine (alcohol, fermented food, dairy, processed meats, etc.) are limited for several weeks, then gradually reintroduced to test tolerance. While some COVID long-haulers report symptom improvement from low-histamine eating:

• There is no consensus by experts on which foods are actually high in histamine, and
• Since the range of potentially offending foods is extensive, this way of eating can be difficult and may cause nutritional deficiencies.

Too few studies have been done concerning this diet’s benefits and risks regarding Long COVID relief, the authors note, and it is not currently recommended for patients. 

The ‘plant-based diet’

Plant-based dieters derive their calories mainly from plant sources: fruits, vegetables, grains, legumes, seeds, and nuts. A balanced, plant-based diet’s antioxidants, good fatty acids, and wide-ranging vitamin, mineral, and fiber content make it effective against inflammation, give it potential antiviral properties, and positively affect immune function. 

Like low-histamine eating, plant-based diets have been promoted by Long COVID patients for symptom management, but there haven’t yet been clinical trials to explore this. Still, evidence shows plant-based eating may alleviate multiple symptoms that also appear in Long COVID: fatigue, headaches, depression and anxiety, and muscle pain.

Bottom line

To help manage Long COVID, White and Wilson advise a Mediterranean diet or balanced plant-based diet for a positive effect on immunity and to help protect against chronic inflammation. “That said, more research is still needed as to how these diets may affect Long COVID.”

*White, S. J. & Wilson, P. B. (2023, January 31). Long COVID: a range of diets are said to help manage symptoms—here’s what the evidence tells us. The Conversation. https://theconversation.com/long-covid-a-range-of-diets-are-said-to-help-manage-symptoms-heres-what-the-evidence-tells-us-197821