Unlike all other epidemics that preceded it in history, Covid-19 will most likely be the first where food will not be scarce, and where the sharp decrease in physical activity and excessive food consumption could amplify the damage to people's health.
History books are full of accounts of populations succumbing to their fears, to scientifically unfounded “medical” advice, and to dietary prohibitions that worsened health conditions. For example, during the Black Death, between 1346 and 1353, when the population in some parts of Europe was reduced by half, the prophylactic measures recommended by the University of Paris included “fumigating homes with chamomile flower incense as well as squares and public places” and “people should abstain from eating chicken or fatty meats and olive oil .” We know today that, in the years preceding the Black Death, northern Europe had been plagued by a long period of food shortages that exacerbated mortality during the peak of the epidemic. Most of the English population before the onset of the Black Death apparently suffered from a chronic shortage of protein, calcium, and vitamin B12, for at least a generation, caused by a prolonged shortage of dairy products. Moreover, famine and disease coexisted throughout the Middle Ages, and the great famine of 1315-1317 was merely a prelude to the Black Death that would emerge years later . During the plagues that ravaged Europe, food shortages occurred because entire villages were decimated, leaving no one to work the land. This work was predominantly manual labor. In general, these epidemics were selective, primarily affecting the elderly and the most frail or sick, even if young and of reproductive age. Disease and famine were strong determinants of the high mortality rates during these periods. The new generation that survived was generally more robust and resistant, with greater immunity and a greater quantity of food available. It was a natural selection.
Another important factor was the need to pay available workers better after the plagues, as there was generally a labor shortage. Employers enticed the few available men with better conditions, which in the Middle Ages meant adding goods – more food and better clothing – to the wages. It is thought that the reduction of food inequalities and more widespread access to food, such as bread, dairy products, fish, or fresh meat, were the most important factors in improving the health and well-being of populations after the Black Death of the 14th century.
We are currently living in different times. While fear, fake news, and anxiety are similar to other periods, the ability of food systems to maintain their production capacity and distribute it without major disruptions is considerably different. We still don't know the true extent of this crisis on food distribution networks, but we believe there won't be a significant reduction in supply. Despite this, the fear of food supply shortages has increased demand and even led to excessive food purchases. These foods, in many cases, are not very perishable due to high amounts of salt, sugar, or other added preservatives, and often have a high energy value. The thoughtless purchase of excessive quantities of processed and high-energy foods (e.g., chocolates, packaged cakes, canned sausages, soft drinks, savory snacks) and the need for prophylactic isolation at home to prevent the spread of the virus may have combined sedentary lifestyles (and the corresponding reduction in usual energy expenditure) with excessive energy consumption. In other words, it has created conditions for increased body fat storage, which is synonymous with obesity and disease. Under normal circumstances, when energy intake exceeds expenditure, the body attempts to mitigate the energy surplus – and corresponding increase in fat – by increasing energy expenditure in physical activity that is not considered exercise (standing, walking, etc.). But in a confinement situation, this "escape valve" is compromised. Additionally, the presence of highly energetic and sensorially appealing foods undermines the capacity for self-control, which will tend to give way to exhaustion given the frequency with which it is challenged.
For these reasons, purchasing decisions during this period of isolation, fueled by fears of stock shortages and little attention to real daily needs, can cause harm that will add to the illness that people are trying to avoid. Excessive consumption of energy, salt, and sugar can worsen the health of a portion of the population, given that more than half of the adult Portuguese population is overweight, more than a third suffers from high blood pressure, and one-tenth suffers from diabetes.
What can we do? Maintain physical distancing (not necessarily social distancing) and, at the same time, find new routines for physical activity at home and combat sedentary lifestyles (today the internet offers hundreds of free short videos of physical exercise from recognized quality institutions such as the University of Porto ). In parallel, it is important to organize food shopping and consumption at home for a period that may be prolonged. In this sense, the role of nutritionists can be very important in encouraging healthy eating during this period. Recently, the DGS (Directorate-General of Health) and the National Program for the Promotion of Healthy Eating made available a manual on COVID-19 and nutrition . This manual was developed with the participation of professors from FCNAUP (Faculty of Nutrition and Food Sciences of the University of Porto), who thus contributed to combating this pandemic. In this document, it is suggested that during this period you should not forget to:
– Eat more fruit and vegetables.
Eat at least vegetable soup for lunch and dinner and 3 pieces of fruit. Within the fruit and vegetable group, opt for those with a longer shelf life, and frozen products can also be a good option, since their nutritional properties are maintained.
Drink water throughout the day, without added sugar.
Maintaining good hydration is essential; drink water throughout the day. Drink 1.5 to 1.9 liters of water per day (8 glasses of water).
– Take the opportunity to bring beans, chickpeas, and peas back to the table.
In times of many canned goods at home, it can be a chance to rediscover the value of legumes, which are sources of fiber and several important nutrients.
– Maintain your daily meal routine, avoiding snacks high in sugar and salt throughout the day.
Don't let this period of spending more time at home encourage you to consume foods with high energy density and low nutritional value. Choose healthier snacks
– Take this opportunity to cook healthy meals with your children.
During this time at home, opportunities arise. Use your free time to teach the younger ones how to cook healthily.
– Eat a complete, varied, and balanced diet, following the principles of the Food Wheel.
Eat foods from all groups of the Food Wheel and drink water daily. Eat larger quantities of foods from the larger groups and smaller quantities of foods from the smaller groups. And vary your diet throughout the day, consuming different foods within each group of the Food Wheel.
The times we are living through are a huge challenge to our societies. These days, adequate food consumption allows us to withstand the present and prepare for the future, so that when this enormous "quarantine" ends, we continue to have health and well-being.
