Moudhi Al-Hajri, Director of the Dietetics and Community Services at PHCC.
 
What are the main concerns related to healthy nutrition during the Coronavirus pandemic that health centers focused on for patients?

Emphasis was placed on patients with chronic diseases, such as, Gestational Diabetes, Type 1 and Type 2 Diabetes, Heart Disease, Stress and other chronic health issues. These cases were given utmost priority.

Did the demand for dietitians increase during the Coronavirus pandemic through phone follow-ups?

The Coronavirus pandemic changed the way patients receive health care through valuable technological solutions allowing health care providers to connect with patients virtually. Thus, the dietetics clinic has been transformed into a remote virtual clinic where patients can consult with specialists via telephone or receive e-consultations. Most patients indicated that their experience was a positive one when they used the services of the dietetics and community clinic. 
The e-consultations were reported to provide comfort and ease since it saved patients the trouble of driving or arranging a babysitter to attend to a physical medical appointment. Many patients also reported that remote nutrition consultations are just as effective as in person consultations at the dietetics and community clinic. Furthermore, given that social distancing is necessary during the COVID-19 pandemic, nutritional counseling over the phone provides a suitable alternative to receive care in a timely manner without the need to leave the house. These advantages led to increased demand for dietitians during the Coronavirus pandemic.  

We continue to conduct video consultations with the same privacy terms as phone consultations, and to use a protection program to maintain the privacy of the patient's personal health information. PHCC encrypts videos to prevent hacking and to prevent unauthorized parties from accessing and viewing the screen. 

What nutritional and immunity boosting awareness programs were recently launched by PHCC health centers?

PHCC health centers launched a number of awareness programs related to healthy nutrition and strengthening the immune system through various media platforms and corporate communication, including print, video and audio media, to promote health awareness among all segments of the society, including citizens, residents, and migrant workers. Hence these programs were in several languages.
The programs included plans to boost the immune system through:
• Adopting a diverse healthy nutrition and a healthy lifestyle
• Promoting physical training and physical fitness
• Establishing a regular sleeping pattern
• Safeguarding mental health by effectively managing tension, stress, anxiety, and fear.
• Launching awareness programs that shed light on the importance of vitamins and minerals intake by promoting the consumption of five fruits and vegetables portions daily to obtain the recommended levels of vitamins.
• Launching programs to help control diabetes and to live with it by adopting a healthy lifestyle.

What are the main requirements for proper nutrition for Coronavirus patients in isolation hospitals? Is there a difference in the meals provided as per the health condition and age of patients?

First, we assess the health status and health history of patients and take their vital signs: height, weight, and body mass index (BMI). Then we perform lab tests to verify some indicators regarding healthy nutrition and body immunity, including blood test, vitamin B12, vitamin D, iron level in the blood, iron storage, zinc level, etc.
Regarding the diet, meals differ from one patient to another. This takes into consideration:
1- The age of the patient, since the needs of a pregnant woman differ from the needs of children.
2- Activity levels, since the activity of administrative employees differ from that of workers. 
3- The health condition, since the diet plan of a diabetic patient is different than that of a cancer patient with regards to calories, quality, quantity and mealtime.
4- Eating habits and religious beliefs, such as vegetarians.
5- Food allergies, such as wheat and milk allergy.

Are there any signs of a stronger immune system as a result of healthy eating? How to test this from time to time?

Once we assess the health status and health history of patients, we take their vital signs such as height, weight, and Body Mass Index (BMI).
We perform tests to verify some indicators regarding healthy nutrition and body immunity, including blood analysis, vitamin B12, vitamin D, iron level in the blood, iron storage, zinc level, etc. Comprehensive lab tests and analyses are done every six months. There are also indications that a healthy diet strengthens the immune system by reducing disease complications and the duration of the disease. We also know that a deficiency in one of the nutrients will affect the strength of the immune system.

Tell us about diets that strengthen the immune system of people with chronic diseases (kidney - heart – blood pressure - diabetes) without health complications?

The dietetics and community clinic have examined all patients with chronic diseases and provided them with specific diet plans to help them control and reduce health complications and live with the disease. The plan included all the necessary nutrients to boost the body’s immunity and help it in adopting a healthy lifestyle.

There was a recent surge in people opting for Vitamin C tablets during the coronavirus pandemic, hoping to strengthen the immune system. Are these tablets detrimental to the health of certain groups of people? 
The truth is that the body cannot store vitamin C, so it discharges it through the kidneys. High levels of vitamin C can cause side effects such as headache, bloating, heartburn, diarrhea, insomnia, and kidney stones. It is preferable to take vitamin C from its natural sources through foods containing vitamin C.  This is considered the best source because you will also get the rest of the nutrients that support and strengthen the immune system.
People should not use any nutritional supplements or vitamins without referring to a dietitian or physician.

Is it harmful to continue diets during virus pandemics and epidemics? 

There are so many commercially popular diets including severe and starvation diet, keto diet, and high-protein diet, but most of them lack the nutrients a body needs, especially during a pandemic since we need these nutrients to strengthen the immune system. Therefore, it is necessary to consult with and benefit from the services at the dietetics and community clinic. You can access this through ‘107’ and receive a varied, balanced and healthy diet that helps compensate for the deficiency of nutrients; it also allows the use of healthy alternatives and provides a healthy system to be adopted for a lifetime. 

What are the important nutrients for the elderly, pregnant women, and children to strengthen their immune system?

Elderly people, aged 60 and above, need to follow digestion-friendly diets that help prevent geriatric diseases. With quarantine measures implemented around the world due to the COVID-19 pandemic, it is necessary to provide nutrient-packed healthy meals, and to ensure continuous movement inside the house and walking outside in the garden.  

Among the most important nutritional advice for the elderly:
- Adopting a healthy lifestyle by eating a balanced diet rich in nutrients that provides the body with all the necessary nutrients, drinking enough fluids, and increasing movement and daily activity.
- Increasing intake of vitamin D through daily sun exposure, and if this is not possible, it is recommended to take vitamin D supplements.
- Increasing vitamin C intake from food sources such as citrus fruits.
- Eating fish and fish oil (omega-3) to boost immunity, and to reduce heart disease and depression (at least once a week).

As for pregnant women, they need special care, especially with regard to their diet, which must contain some elements and vitamins beneficial to them and their unborn baby.
Among the most important nutrients that a pregnant woman must adhere to are folic acid, iron, vitamin D, magnesium, fish oil, and zinc.

As for children, the most important tips to strengthen the immune system of children are:
- Maintaining a balanced diet, for healthy food is one of the ways to boost children’s immunity significantly. Food that boost the immune system include fruits, vegetables, fish, meat, legumes and whole grains, which contain important nutrients that strengthen immunity and reduce the chances of catching colds, flu, and other illnesses.
- Exercising regularly is one of the most important ways to boost children’s immune system. Ensure less time before TV and computers and encourage a more active lifestyle.
- Exposure to sunlight. Recent studies have shown that there is a direct relationship between exposure to sunlight and the strengthening of the immune system.
- Washing hands regularly helps reduce bacterial and viral infections, which helps boost children’s immunity.
- Do not skip any vaccine. It is important for a child to take all vaccinations on their regular dates, which strengthen immunity and prevent many diseases.
- Establish a good sleeping pattern, since a recent study has proven that it helps children boost their immune system. Children aged 3 to 5 must get between 10 to 13 hours of good sleep, and children between the ages of 6 to 13 get an average of 11 hours of sleep, and teenagers between 14 and 17 should get 10 hours a day.
- Keep children away from smokers, because smoking endangers children’s immunity and exposes them to the risk of diseases.  
- Reduce the intake of sugar, as it can cause a lot of damage that can affect the immune system in children.
- Drink enough water throughout the day.

Finally, I would like to mention that boosting the immune system is a cumulative process and cannot be done overnight.