Dawn Woodward examines the impact that some patient’s lockdown diet will have had on their oral health – not to mention their immunity to disease.
In April, three leading food experts wrote an open letter to the government. They called for a coordinated public health campaign to promote the importance of nutrition in the fight against coronavirus.
They wrote a letter, titled ‘Food planning for health in a time of coronavirus crisis’. The experts stated ‘there is considerable evidence that nutritional status crucially affects our immune responses, as well as wider health and wellbeing’.
One central concern was the food supply chain. This enables the wide access to food that can strengthen the immune system and aid recovery.
The immune system is what protects us from ‘infectious agents that exist in the environment (bacteria, viruses, fungi, parasites) and other noxious insults’. Our level of nutrition heavily determines how efficiently our immune system functions (Marcos et al, 2003).
Good nutrition and eating well has always been about far more than maintaining a healthy weight. This became part of the conversation too when headlines linked obesity with an increased risk of becoming seriously ill with coronavirus.
A long-term concern
The alarm about food planning during the coronavirus pandemic reflects long-term concerns about eating for health in the UK. Years of data indicates that people aren’t always making good choices, despite the ongoing advice.
As per the last figures for England, in 2018/19, there were 11,117 hospital admissions directly attributable to obesity (an increase of 4% on 2017/18) (NHS, 2020).
For children, the same data set found 20% of year six children were obese. A greater prevalence of dangerously overweight children in deprived areas is apparent.
In the UK, the lockdown period didn’t just limit how active we could be. For many of us it changed how and what we ate.
Some of these changes were beneficial. Anyone used to a takeaway sandwich during their work break will have discovered the perks of lunch at home. Eating homemade is generally a healthier option than a takeaway for any meal. It is certainly kinder to your bank balance.
Other positives? More meal planning, and shopping for food less frequently. Also, having limited access to certain ingredients, forced us to think ahead.
Families were eating together more often. They were also cooking with children. It’s a well-worn method to get them to appreciate food. By taking pride in preparing a meal for others to enjoy.
A reflection of the negative changes, appear in the experts’ letter too. Due to the lack of choice at home, for many school-age children it would have been highly detrimental to not have a hot school lunch every day.
The Association of UK Dieticians website contains plenty of anecdotal evidence of people eating too much of the ‘wrong’ things (and drinking too much alcohol) out of anxiety, or boredom during this period.
Comfort foods, which people often reach for when they eat emotionally, tend to be high in fat and sugar. Being indoors for most of the day, in stressful circumstances, meant that many failed to find one good reason not to reach for that third biscuit if they needed a pick-me-up.
(A caveat should be added here that if a certain ‘unhealthy’ food does make you genuinely feel good, this would have been the time to enjoy it, in moderation.)
Balance and support
The problem with all this is the lack of balance and an under-appreciation of the link between nutrition and immunity. Good nutrition will not just make you feel and look better. It will also give you the tools to reduce the risk and impact of illness.
Even a mild deficiency of certain nutrients can alter an immune response. These micronutrients include zinc (in meat, whole grains and nuts), vitamins A, C, E (rich sources are fresh fruit and vegetables) and folic acid (in leafy greens and citrus fruits) (Chandra, 2002).
You cannot separate oral health and general health. Nutrition is a modifiable risk factor for dental situations that will impact/exacerbate certain conditions, such as periodontal disease (Zohoori and Duckworth, 2020).
Bacteria in the oral cavity can lead to inflammation that could impact on the immune response. It must be managed and removed efficiently with good home cleaning. Also it should be monitored with regular maintenance visits when possible.
Support patients by including nutrition as part of your preventive message, along with instruction on optimal cleaning.
You’ll get maximum compliance if you recommend tools they will enjoy using. Tools such as the Hydrosonic Pro electric toothbrush from Curaprox, with ultra-fine Curen filaments and Curacurve ergonomics to gently remove plaque.
Many patients are now motivated in better self-care. We have a good opportunity to teach them how to improve their immunity and general good health via improved nutrition. We can use this current situation to make our preventive message stronger. Our patients will understand how all the different threads of wellbeing are linked and what they can do to protect themselves.
For references, please email [email protected].
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