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Popular Science Guidance: Zeng Yaochi, Department of Nutrition, Shenzhen Hospital of Traditional Chinese Medicine

Respiratory tract infection is very common and can occur all year round, especially for infants, the elderly and people with low immunity. At present, novel coronavirus (COVID-19 for short) is popular. Virulence, personal susceptibility and drug resistance are the key factors. Good personal nutrition can reduce the risk of illness and improve the prognosis of the disease.

expert

During the COVID-19 epidemic, individuals and families should not only avoid contact with pathogens as much as possible, but also ensure a good nutritional status and enhance their resistance.

Recently, the Parenteral Nutrition Branch of Chinese Medical Association (CSPEN) put forward the following 10 expert suggestions on the prevention and control of epidemic situation in novel coronavirus, and suggested that you follow them:

1

Eat high-protein food every day, including fish, meat, eggs, milk, beans and nuts, and increase the amount on the basis of usual; Do not eat wild animals;

2

Eat fresh vegetables and fruits every day and increase the amount on the basis of usual;

three

Drink plenty of water, not less than1500ml; Every day;

four

The types, sources and colors of food are rich and varied, not less than 20 kinds per day; Don't be partial to food, mix meat and vegetables;

five

Ensure adequate nutrition, increase the amount on the basis of the usual diet, and eat well.

six

For patients with insufficient diet, the elderly and chronic consumptive basic diseases, it is suggested to increase commercial enteral nutrition (special medical food) and add no less than 500 calories every day;

seven

Don't go on a diet to lose weight during the COVID-19 epidemic;

eight

Work and rest regularly, get enough sleep, and ensure that the sleep time is not less than 7 hours every day;

nine

Carry out individual physical exercises with a daily cumulative time of not less than 1 hour, and do not participate in group sports activities;

10

During the epidemic in COVID-19, it is suggested to supplement some health foods such as multivitamins, minerals and deep-sea fish oil.

For "Article 6: It is suggested to increase commercial enteral nutrition (special medical food) for patients with insufficient diet, the elderly and chronic consumptive basic diseases, and supplement at least 500 calories a day", please click on the blue word to see the two tweets "Competition among milk, chicken soup, health products, food homogenate and special medical food" and "Promoting rehabilitation and improving curative effect, starting with enteral nutrition treatment". If you can't eat or eat very little,

We will focus on "10". During the epidemic in COVID-19, it is suggested to supplement some health foods such as multivitamins, minerals and deep-sea fish oil, because respiratory infection is closely related to low autoimmune function and lack of related nutrients.

vitamin A

It is an essential trace element and anti-infective vitamin for human body, which can regulate the cellular and humoral immune function of human body, thus achieving the purpose of improving the body's resistance and immunity and effectively resisting external infection. Vitamin a deficiency can reduce the levels of IL- 1 and IgG, thus impairing the balance between respiratory barrier and normal flora, reducing the ability of respiratory system to remove bacteria and viruses, and finally inducing respiratory infection?

Usually, we define the serum vitamin A level below 0.35μmol/L as clinical vitamin A deficiency. 0.35~0.70μmol/L is subclinical vitamin A deficiency; 0.70 ~ 1.05μmol/L is suspected of subclinical vitamin A deficiency, that is, marginal vitamin A deficiency.

Consumers are advised to eat more animal foods rich in vitamin A, especially animal liver, vitamin A fortified food and cod liver oil to avoid vitamin A deficiency.

vitamin C

According to the comprehensive research results, vitamin C supplementation (200 ~1000 mg/d) can reduce the duration of upper respiratory tract infection and help to improve symptoms, although it has not been found to prevent upper respiratory tract infection. Considering the frequency of upper respiratory tract infection, improper antibiotic prescription and the safety of vitamin C, vitamin C supplementation is reasonable, especially for children under 6 years old and children with high frequency of upper respiratory tract infection.

In addition to supplementation, it is safer to take enough vitamin C through diet. The vegetables with the highest vitamin C content are: persimmon pepper, Chinese kale, pea seedlings, oil sprouts, peppers (green tips), cauliflower, sweet potato leaves, bitter gourd, broccoli, radish sprouts and so on.

Fruits with high vitamin C content are: Rosa roxburghii, Jujube, Jujube, Seabuckthorn, Kiwifruit, Red Fruit, Strawberry, Papaya, Longan and Litchi.

cypridopathy

There are specific vitamin D receptors in various cells, and 1.25-(OH)2D3 has many effects on the immune system. Including regulating the differentiation of antigen presenting cells, the proliferation of lymphocytes and the secretion of cytokines; Inhibit the production of interleukin IL-12 by macrophages and dendritic cells; Down-regulate the expression of MHC-II molecules and costimulatory molecules such as B7; Directly inhibit cell proliferation and its ability to secrete IL-2 and interferon (IFN-γ); It acts on helper T cells, indirectly inhibits the synthesis and secretion of immunoglobulin by B cells, and increases the activity of inhibitory cells.

A British study shows that the circulating 25(OH)D level is negatively correlated with the respiratory infection rate. In addition, the anti-inflammatory effect of vitamin D can improve resistance and reduce excessive tissue damage during infection.

zinc (Zn)

Is trace element zinc related to human immune function? Once the zinc content in the body is insufficient, it will have a serious impact on the immune system and easily lead to respiratory infections?

The content of zinc directly affects the immune system of human body, and its mechanism of action is roughly as follows:

(1) can promote the secretion of Th 1 cytokines and inhibit the secretion of Th2 cytokines, thus reestablishing the balance of Th 1/Th2?

(2) Improve IgG level, stabilize mast cell membrane, reduce airway inflammation and inhibit asthma?

(3) Zinc is a good antioxidant and can participate in the formation of Cu/Zn-SOD. Activate glutathione peroxidase, etc. To reduce airway inflammation?

(4) Zinc can also participate in maintaining the integrity of human epithelial cells and tissues, and play a positive role in the repair of epithelial cells, thus improving the anti-infection level of human body and avoiding respiratory infection?

Common zinc-rich foods include oysters, dried clams, scallops, squid and cuttlefish. For people with low immunity who can't meet zinc intake in daily food, zinc can be supplemented as appropriate.

Probiotics can prevent respiratory tract infection and reduce the time and frequency of infection and the time of antibiotic use. As early as 20 13 years ago, WPIO passed the patent application of rhamnose LGG- Bifidobacterium BB- 12 produced by Chr Hansen A/S company in Denmark for preventing and treating upper respiratory tract infection, and confirmed its clinical effect (rhamnose LGG- Bifidobacterium BB- 12), which was used to shorten the time for teenagers and adults.

American Journal of Respiratory and Critical Care Medicine published a double-blind randomized controlled experimental study of probiotics in preventing ventilator-associated pneumonia. Studies have shown that Lactobacillus rhamnosus LGG is beneficial to prevent ventilator-associated pneumonia, with the incidence rate reduced by 22% and the use time of antibiotics reduced by 3 days.

A study on the prevention of non-respiratory tract/digestive tract infections by probiotics in 742 children aged 5~ 16 years in Pediatrics magazine showed that the incidence of respiratory tract and digestive tract infections in children could be reduced by 12% and 29 cfu/d when Lactobacillus rhamnosus was given for 7 consecutive days during hospitalization and after discharge.

Samuli Rautava published a randomized, double-blind, controlled study on reducing the risk of acute infection in young children by using specific probiotic strains. Giving LGG+BB-121×1010 cfu/d can reduce the incidence of recurrent respiratory infections and otitis media in children.

1

Lycium barbarum 10g, chrysanthemum 6g and kudingcha 2g instead of tea.

Efficacy: quenching thirst and promoting fluid production, clearing away heat and reducing fire.

2

Folium Mori 5g, Fructus Siraitiae Grosvenorii 1, Rhizoma Imperatae 5g and Radix Isatidis 5g for tea.

Efficacy: clearing away heat and toxic materials, moistening intestines and relaxing bowels.

three

Astragalus root 5g, Cornus officinalis 5g and safflower 1 ~ 2g are used for making tea.

Efficacy: it can warm the stomach and strengthen the body.

four

5g Dendrobium, 2g Osmanthus fragrans, for making tea.

Efficacy: nourishing yin and moistening lung, nourishing stomach and promoting fluid production.

five

Appropriate amount of brown sugar, ginger 10g, and 3 pieces of pepper (ground) instead of tea.

Efficacy: resolving phlegm and relieving cough, dispelling wind and dispelling cold.

six

Astragalus membranaceus 10g, Codonopsis pilosula 10g and Lonicera japonica 10g instead of tea.

Efficacy: Enhance immunity, clear away heat and toxic materials.

seven

5g of licorice, 5g of Uncaria rhynchophylla and 5g of Astragalus, instead of tea.

Efficacy: promoting blood circulation and detumescence, clearing away heat and toxic materials.

eight

1 Siraitia grosvenorii, 2 boat-fruited Sterculia, 5g Astragalus membranaceus, used for making tea.

Efficacy: clearing away heat and relieving sore throat, resolving phlegm and relieving cough.

nine

30g of cogongrass rhizome, 30g of reed rhizome and 0/5g of kudzu root/kloc-instead of tea.

Efficacy: promoting fluid production to quench thirst, clearing away heat and removing annoyance.

10

Sydney, honey, the right amount, first boil pears, then add honey, on behalf of tea.

Efficacy: nourishing yin and moistening lung, nourishing stomach and promoting fluid production.

1 1

First-line medical staff: honeysuckle 5g, chrysanthemum 5g, Belamcanda 5g, licorice 3g, Siraitia grosvenorii 1/3, boiled water instead of tea.

Efficacy: clearing away heat and cooling blood, promoting fluid production and relieving cough, eliminating phlegm and relieving sore throat.

Tips: The above dietotherapy remedies can't be used as COVID-19's remedies, but can only be used as an auxiliary application to relieve symptoms and promote rehabilitation. The treatment of traditional Chinese medicine should be based on syndrome differentiation. For details, please refer to the 2020 edition of "Fanggan Decoction" Chinese Medicine Health Care Prescription launched by the Municipal Hospital of Traditional Chinese Medicine. (Click on the blue word to view the content)

Carrot and corn sparerib soup 1 (strengthening the spleen and stomach, strengthening the body)

Flammulina velutipes thin broth 2 (antibacterial, anti-inflammatory, body-building)

Asparagus soup 3 (nourishing yin and moistening dryness, resolving phlegm and relieving cough)

Cordyceps Chicken Soup 4 (relieving cough and resolving phlegm, improving immunity)

Codonopsis pilosula and mushroom chicken soup 5 (nourishing blood, promoting fluid production, invigorating spleen and benefiting lung)

six

Chicken soup with yam and codonopsis pilosula (raw materials: yam 15g, 6 red dates, codonopsis pilosula 10g, chicken 250g. Efficacy: invigorating qi and improving immunity)

seven

Shenqi Dihuang Decoction (raw materials: Radix Adenophorae 10g, Radix Astragali 20g, Radix Rehmanniae 15g, ribs 250g. Efficacy: benefiting stomach and promoting fluid production, resolving phlegm and relieving cough)

eight

Radix Rehmanniae Preparata and Radix Codonopsis Decoction (raw materials: Radix Rehmanniae Preparata 10g, Rhizoma Polygonati 10g, Radix Codonopsis 10g, and lean meat 250g. Efficacy: Yiqi Yangxue, Jianpi Runfei)

nine

Dangshen Baihe ribs soup (raw materials: Dangshen 15g, Lily 20g, ribs 250g. Efficacy: Yiqi Jianpi, Ziyin Runfei)

10

Radix Puerariae and Radix Astragali lean broth (raw materials: 20 grams of Radix Puerariae and Radix Astragali each, 250 grams of lean meat. Efficacy: promoting fluid production to quench thirst, benefiting qi and promoting blood circulation)

The above soup can be based on personal preference, taking local materials as the principle, and choosing ribs, chicken, lean meat and so on.

Smoking leads to the increase of nicotine content in human blood, which is easy to cause vasospasm, transient hypoxia in local organs, especially the decrease of oxygen content in respiratory tract and internal organs, which is easy to weaken human disease resistance, and so is alcohol. Respond to the epidemic and advocate quitting smoking and limiting alcohol. How to save immunity? Click on the blue text to see more information.

Outpatient service time of nutrition department:

Visit from Monday to Sunday (see the service number or registration platform of Shenzhen Traditional Chinese Medicine Hospital 160 for details).

Address:

Northeast of the first floor of the inpatient department of Shenzhen Hospital of Traditional Chinese Medicine,No. Hua Fu Road 1, Shenzhen.

Nutrition Department Office Tel:

0755-23987 176 to 2340

Nutrition clinic tel:

0755-88607543, ext. 2429

Department of Nutrition, Shenzhen Traditional Chinese Medicine Hospital

The long-term orientation of nutrition department is a comprehensive medical and technical department based on clinical service, with teaching and training as the mainstay and scientific research as the supplement. The Department of Nutrition regularly holds on-site and online lectures and broadcasts them live on the official WeChat account. Join the China Medical Media Alliance. Participate in the discussion of multiple MDT teams and difficult cases. Since 2009, he has published 4 SCI journal papers, 8 CSCD core journal papers 1, presided over the project1of the Provincial Science and Technology Department, 2 projects of the Provincial Health Department and 2 projects of the Municipal Health Planning Commission, and participated in the compilation of teaching materials such as Food Nutrition and Food Safety and Treatment of Overweight and Obesity.

Outpatient service:

Non-drug intervention in weight management (applicable population: simple obesity, type II diabetes, hypertension caused by obesity, hyperglycemia, hyperinsulinemia, hyperlipidemia, apnea hypopnea syndrome, hyperuricemia, fatty liver, polycystic ovary syndrome, postpartum obesity and other people who need to reduce fat, increase muscle and shape).

Perioperative nutritional therapy for various surgical diseases

Nutritional intervention of homocysteine

Nutritional intervention of hyperuricemia

Nutritional intervention of osteoporosis

Nutritional intervention of sleep disorder

Nutritional intervention of food allergy and food intolerance

Nutritional intervention for adolescents and children

Perinatal nutrition intervention clinic (gestational diabetes mellitus, pregnancy-induced hypertension, formulation of nine kinds of monthly meals, puerperal lactation, promoting emulsion, returning milk, etc.). ).

Family nutrition intervention for various chronic diseases (chronic kidney disease, diabetes, tumor, cerebral infarction, hepatobiliary disease, chronic obstructive pulmonary disease, etc.). ).

Hospitalization business:

Nutritional risk screening, nutritional assessment, nutritional treatment and nutritional education for hospitalized patients; Carry out "clinical nutrition quality service" to provide nutritional treatment integrating dietotherapy, enteral nutrition and parenteral nutrition for hospitalized patients. Nutritional management of perioperative accelerated rehabilitation for surgical patients.

Expert introduction

Zengyaochi

Deputy chief physician of nutrition department

Outpatient service time:

Every Monday and Friday 14:30- 17:30.

Every Wednesday and Saturday at 8: 00 am-12: 00 am.

Kuang Hua

Nutritionist

Outpatient service time:

Every Sunday at 8: 00 am-12: 00 am.

plum

Nutritionist

Outpatient service time:

Every Thursday morning from 8: 00 to 12: 00.

References:

L Suggestions on prevention and treatment of novel coronavirus infection by dietary nutrition experts of Chinese Medical Association Parenteral Nutrition Branch (CSPEN), 2020, 1.

Novel coronavirus prevention manual. Hubei Science and Technology Press, 2020, 1. Nigerian children under five with diarrhea are deficient in vitamin A. AFR Health Science, 20 18, 18 (3): 737-742.

Lβ-apo- 10- carotenoids support normal embryonic development during vitamin A deficiency. Sci Rep,20 18,8( 1):8834。

Does the immunity of athletes and soldiers have an optimal vitamin D status? Immunization Revision 20 16, 22: 42–64.

In British adults, vitamin D levels are linearly related to seasonal infections and lung function. Nutritional supplements. 20 1 1, 106: 1433- 1440.

Efficacy of vitamin c in preventing and treating upper respiratory tract infection. Meta-analysis of children. European Journal of Clinical Pharmacology. 20 19,75(3):303-3 1 1.

Lactobacillus rhamnosus and Bifidobacterium animalis subspecies. Risk or treatment of upper respiratory tract infection. Patent number: wo/2013104783a1.

Clinical and economic impact of probiotic consumption on respiratory tract infection: Canada's forecast. PLoS One,20 16, 1 1( 1 1):e 0 166232。

Probiotic prevention of ventilator-associated pneumonia: a randomized clinical trial. Am J respiratory crisis nursing medicine 20 10,182:1058-1064.

Lactobacillus GG prevents gastrointestinal and respiratory tract infections in hospitals. Pediatrics, 20 10,125: e1171-e177.

L specific probiotics reduce the risk of acute infection in infants-a randomized, double-blind, placebo-controlled study. British journal of nutrition. 2009, 10 1: 1722– 1726。

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