Translated from - Chinese Journal of Food Hygiene

Beijing Wuliande Public Welfare Foundation Micro Ecological Health Management Expert Committee

Ecological Health and Human Ecology Professional Committee of the Chinese Society of Ecology

Chinese Nutrition Society Probiotics, Prebiotics and Health Professional Committee

According to the novel coronavirus Infection Prevention and Control Plan (Tenth Edition), which specifies the management requirements of "home self-care can be taken for mild cases", the Expert Consensus on Dietary Guidance for People with Intestinal Dysfunction Caused by Omicron Infection (hereinafter referred to as the Consensus) is proposed as follows after full communication with relevant experts on the current population with Omicron virus infection and gastrointestinal symptoms (such as vomiting, diarrhea, etc.):

1、 Key points for intestinal fluid replacement during infection

Due to fever, sweating, vomiting, and diarrhea, electrolyte imbalance can occur, leading to muscle weakness caused by hyponatremia and hypokalemia. Hypokalemia is more likely to cause arrhythmia, and in severe cases, it can be life-threatening. The Consensus suggests that after infection, targeted treatment at home should first focus on drinking plenty of water.

Oral rehydration is a recommended measure, and when there is a large amount of diarrhea, oral OTC drug rehydration salts or homemade oral rehydration salts can be taken. We do not recommend sports drinks (electrolyte drinks) as a priority. It is recommended to use them only for emergency situations where there is no oral OTC medication for rehydration salts and low sodium salts.

The common formula for homemade oral rehydration salts is as follows:

Formula 1: 1 L of cold boiled or purified water, half a teaspoon (about 3 g) of edible salt (low sodium salt is preferred as it contains some potassium salt), 6 teaspoons (about 24 g) of edible sugar and lemon slices, lemon juice or orange juice. It is best to use glucose, but sucrose (white sugar, soft white sugar, rock sugar, brown sugar, etc.) can also be used. Lemon slices, lemon juice, and orange juice are mainly used to improve taste; Fresh fruits rich in potassium can be consumed separately and in moderation to assist in supplementing potassium.

Formula 2: 500 mL soybean milk or rice soup+half a teaspoon (about 3 g) of low sodium salt [refer to China's Diagnostic and Treatment Specifications for Children's Acute Infectious Diarrhea (2020 Edition)]. soybean milk or rice soup is not only rich in amino acids and potassium, but also has the effect of invigorating the spleen and stomach.

Formula 3: 4 cups (800 mL) of electrolyte beverage, half a teaspoon (approximately 3 g) of edible salt.

Most of the minerals needed by the human body can be obtained from food. Symptoms such as fatigue, fatigue, dizziness, and arrhythmia can be supplemented with potassium rich foods.

The first choice for oral fluid replacement is mainly due to the fact that the human body can compensate for the lack of electrolytes and adjust absorption on its own, which is safer for blood potassium stability than intravenous infusion. For a small number of people with severe diarrhea, it is recommended to seek medical treatment in a timely manner.

The composition of products specifically designed for treating diarrhea is very diverse, with the overall principle of daily oral potassium supplementation of 0.2 g or more, up to 1.0 g, and no more than 3.2 g (special attention should be paid to those with kidney function problems).

2、 Imbalance of intestinal microbiota and suggestions for regulation

People with diarrhea symptoms may experience dysbiosis of the gut microbiota, leading to an imbalance in the microbiota; If some people develop bacterial infection complications in the later stage of treatment with Omicron, they may use antibiotics, which further exacerbates the imbalance of intestinal microbiota. Restoring and adjusting the balance of intestinal microbiota can help patients recover.

It is recommended that infected individuals consume foods that promote gut microbiota balance and are rich in dietary fiber (such as fresh fruits and vegetables, legumes, and whole grains), and can also supplement probiotics, prebiotics, and prebiotics in moderation to alleviate diarrhea symptoms and improve the course of the disease. The above measures have a certain effect on repairing the intestinal mucosal barrier function, enhancing its absorption of electrolytes, restoring intestinal immune function, reducing inflammatory reactions, and inhibiting the adhesion, growth, and invasion of pathogens. Given the population specificity of different microecological preparations, not all product types are suitable for all populations. Infected individuals can choose legitimate and scientifically based products according to their own situation. For those who use antibiotics, it is recommended to choose probiotics that are not easily affected by antibiotics.

3、 Ensure sufficient intake of dietary fiber

During the onset of the disease, it is recommended to have a light diet and consume sufficient dietary fiber every day. After dietary fiber enters the human digestive tract, it is beneficial for maintaining normal intestinal function (water absorption and shaping) and improving intestinal immunity. Whole grains, fresh fruits, vegetables, legumes, and other foods are rich in dietary fiber. Among them, legumes, seaweed, and other foods also have potassium supplementation effects (such as bananas at 25 mg/kg, black beans at 138 mg/kg, or soybeans at 150 mg/kg, dried seaweed at 180 mg/kg, or dried mushrooms at 120 mg/kg).

4、 Dietary recommendations to enhance immunity

Many infected individuals face difficulties such as loss of appetite, sore throat, and general fatigue during the recovery period from fever to fever reduction, resulting in slow recovery due to weakened immunity. Therefore, it is recommended to have a light diet and first ensure an appropriate intake of high-quality protein (such as lean meat, eggs, milk, fish, shrimp, etc.). Eat more fresh vegetables and fruits rich in various vitamins (500g of vegetables per day, 200-350g of fruits per day). Avoid greasy, raw, cold, spicy and stimulating foods. It is recommended to mainly steam and boil food (choose an edible method according to personal taste, without special restrictions on cooking methods). Eat small meals frequently. For patients without special illnesses, there are no dietary restrictions. Eat as much as possible to ensure sufficient energy. For people with insufficient food intake, the elderly, and chronic disease patients, they can choose to consume fortified foods, special medical formula foods, or nutrient supplements to supplement their intake of protein and vitamins.

In addition, specific dietary recommendations for different disease stages are as follows:

During fever: On the basis of a light diet, ensure the supply of high-quality protein and vitamins. Ensure one egg, one box of milk (250 mL), one cup of yogurt, and one fresh fruit every day.

2. Rehabilitation period: Focus on increasing the intake of high-quality protein on the basis of regular diet, and pay attention to food balance.

3. The recommended recipe is as follows:

Protein: steamed egg soup (or steamed egg with minced meat), steamed fish, minced meat and tofu, minced meat and vegetable soup, yam chop soup, lotus root chop soup, various steamed lean meat balls, bean curd jelly served with sauce, soybean milk, milk, yogurt, etc.

Main food: rice, noodles, Congee, millet Congee, corn Congee, mashed potatoes, Babao Congee, dumplings, etc.

Vegetables: Various seasonal vegetables are mainly stir fried and blanched.

Fruit: Various fresh fruits rich in vitamins.

Expert consensus drafting expert list (the order of drafting experts is not in any particular order):

Wu Yongning, Director of the Microecology Committee of the Beijing Wuliande Public Welfare Foundation, Editor in Chief of China Food Hygiene Journal, and Researcher at the Key Laboratory of Food Safety Risk Assessment of the National Health Commission (National Food Safety Risk Assessment Center)

Zhang Jianzhong, Honorary Chairman of the Ecological Health and Human Ecology Professional Committee of the Chinese Ecological Society, and Researcher at the Institute of Infectious Disease Prevention and Control of the Chinese Center for Disease Control and Prevention

Yang Ruifu, Chairman of the Probiotics, Prebiotics, and Health Committee of the Chinese Nutrition Society, and Researcher at the Military Medical Research Institute of the Academy of Military Sciences

Wang Shuo, Vice Dean and Professor of the Institute of Public Health at Nankai University School of Medicine

Yuan Jieli, Vice Chairman of the Microecology Branch of the Chinese Preventive Medicine Association, Executive Editor and Editorial Director of the Chinese Journal of Microecology

Chen Hongbing, Dean and Professor of the Sino German Joint Research Institute at Nanchang University

Li Guoliang, Dean and Professor of the School of Food Science and Engineering at Shaanxi University of Science and Technology

Li Jingguang, Director and Professor of the Food Safety Innovation Unit (National Food Safety Risk Assessment Center) of the Chinese Academy of Medical Sciences

Li Zhaojie, Professor at the School of Food Science and Engineering, Qingdao Agricultural University

Shao Yi, Researcher at the National Food Safety Risk Assessment Center

Sang Yaxin, Dean and Professor of the School of Food Science and Technology at Hebei Agricultural University

Liu He, Vice President and Professor of Bohai University

Fan Lihua, Associate Professor at the School of Food Science and Engineering, Shaanxi University of Science and Technology

Yu Ping, Senior Engineer at Jiangxi Renren Health Micro Ecological Technology Co., Ltd

Liu Jiaying, Associate Professor of China Agricultural University

Wang Yuping, Associate Professor at the School of Group Medicine and Public Health, Peking Union Medical College

Professor Ulina from the School of Food Science, Shenyang Agricultural University

Li Fang, Deputy Chief Physician of Jinan Central Hospital

Professor Qian Fang from Dalian University of Technology

Professor at Manchao New Northeast Agricultural University

Wu Junrui, Professor at the School of Food Science, Shenyang Agricultural University

Zhao Ruizhen, Director and Chief Physician of the Preventive Medicine Center at the Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine

Tuo Yanfeng, Associate Professor at Dalian University of Technology

Liu Xinli, Director and Professor of the Institute of Biopharmaceutical Engineering at Qilu University of Technology

Yu Huan, Associate Professor at Jiangxi University of Traditional Chinese Medicine

Li Kun, Director of the Medical Department and Deputy Chief Physician of the First Affiliated Hospital of Shandong First Medical University (Qianfoshan Hospital, Shandong Province)

Li Ming, Professor at Dalian Medical University

Wang Yongjun, attending physician at the First Affiliated Hospital of Shandong First Medical University (Qianfoshan Hospital, Shandong Province)

Tang Chunjin, Executive Vice President of the Aromatherapy Industry Branch of the China Folk Traditional Chinese Medicine Research and Development Association, and Chairman of Chongqing Haisi Lan Technology Co., Ltd