Transcript Your mother was right- you really should eat your broccoli…

Your Mother Was Rightyou really should eat your brussel sprouts…
How nutrition affects your Immune System
Victoria Dimitriades, MD
Clinical Assistant Professor of Pediatrics
Divisions of Allergy/Immunology and Rheumatology
Louisiana State University Health Sciences Center
Disclosures

I have nothing to disclose, other than
my expertise in eating.
Complement
System
T cell
Immunity
Phagocytes
Immune
Function
Mucous
Membranes
B cell
Immunity
Nutrition-Immunity link

Macronutrient deficiency
◦ Protein, Calories
◦ Malnutrition is the most common cause of
immune deficiency world-wide

Micronutrient deficiency
◦ Elements, Vitamins

Overnutrition
◦ Excess of macronutrients
Protein-energy malnutrition

Causes
 Limited food access
 Chronic disease
 Chronic Pain
 Dental/Feeding issues
 Medications
 Severe dieting
HAS Clinical Guidelines 2007
Protein-energy malnutrition

Innate Immunity
 Impaired phagocyte function

Adaptive Immunity
 T cells
 Decreased numbers and function
 Increased susceptibility to opportunistic
infections
Micronutrients
Iron
 Zinc
 Copper
 Selenium
 Vitamins

Micronutrients- Iron
Aids in T cell development
 Generates some “reactive oxygen
species” to kill pathogens

Micronutrients- Iron

Deficiency associated with:
 Anemia, paleness, fatigue
 Infections

Immune issues
 Reduced phagocyte activity
 Impaired T cell response
 Risk of parasite and Candida infections
 Reduced immunoglobulin levels
Micronutrients- Iron

Supplementation
 Recommended: 7-18mg/day
Micronutrients- Zinc



Stimulates T cell production and
subtype switching
Stimulates complement system
Stimulates phagocytes
 Reduction in risk of pneumonia
 Reduction in common cold symptoms
 Reduction in infectious diarrhea (worldwide)

Antioxidant/Inflammatory Control
Micronutrients- Zinc

Deficiency associated with:
 Skin lesions, hair loss
 Loss of taste and smell, diarrhea
 Infections, poor wound healing

Immune issues
 Increased susceptibility to infections (skin
and GI system)
 Impaired phagocytosis
 Impaired NK cell activity
 Low T and B cells
Micronutrients- Zinc

Supplementation
 Recommended daily
dose: 3-11 mg/day of
elemental zinc
Micronutrients- Copper

Promotes T and B cell responses
◦ IL-2 production

Promotes phagocyte function
Micronutrients- Copper

Deficiency associated with:
 Neutropenia, anemia
 Neurologic issues

Immune issues
 Low white blood cells
 Reduced T cell responses
 Reduced phagocyte responses
 Neutropenia
Micronutrients- Copper

Supplementation
 Recommended: 350-900 mcg/day
Micronutrients- Selenium

Antioxidant effects
 Promotes production of limited reactive
oxygen species (ROS) to fight infections

Stimulates general immune
responsiveness
 T and B cell activation
 Cytokine release
Micronutrients- Selenium

Deficiency associated with:
 More severe effects of viral infections
 Muscle aches

Immune issues
 Loss of antioxidant host defense
 Decreased white blood cell and NK cell
function
Micronutrients- Selenium

Supplementation
 Recommended daily: 20-55 mg/day
Vitamin A
Supports structure and function of
mucosal cells of eyes, lungs,
gastrointestinal tract
 Promotes response to bacterial
infections
 Affects growth and function of B cells
 Affects activation of T cells

Vitamin A

Deficiency associated with:
 Dry eyes, night blindness
 Diarrhea
 Respiratory infections
 Fat malabsorption
Vitamin A

Immune issues:
 Loss of structure/function of cells on
mucosal surfaces
 Impaired resistance to infections, especially
gastrointestinal
 Diminished function of innate immunity
 Impaired B and T cell responses
Vitamin A

Supplementation
 Recommended: 1000-3000 IU/day
Vitamin B
B1- thiamin
 B2- riboflavin
 B3- niacin
 B5- pantothenic acid
 B6- pyridoxine
 B7- biotin
 B9- folic acid
 B12- cyanocobalmin

Vitamin B- all

B1- thiamin
◦ Aid in antibody responses

B2- riboflavin
◦ Aid in antibody responses
B3- niacin
 B5- pantothenic acid

◦ Aid in production and release of antibodies

B6- pyridoxine
◦ Aids in T and B cell production and maturation
B7- biotin
 B9- folic acid

◦ Aids in T cell production and maturation

B12- cyanocobalamin
◦ Promotes NK cell activity, aids in T and B cell production
Vitamin B- all

Supplement
◦ Range dependant on each vitamin
Vitamin C

Antioxidant effects
 Protects cells from reactive oxygen species (ROS)
made by the body to control infections
 May have anti-viral activity
 May aid in symptoms of common cold because of ROS
function on surface of airway and lung epithelium
 Improvement in both innate and adaptive
immunity function
Vitamin C

Deficiency associated with:
 Purpura/petechiae
 Poor wound healing (scurvy)

Immune issues:
 Impaired collagen synthesis for barriers
 Impaired antioxidant performanceincreased free radical production
Vitamin C
 Supplementation
 Recommended: 75-90 mg/day
Vitamin D
Necessary for phagocytic activity
 Limits inflammatory response
promoted by specific T cell subtypes
 Promotes wound healing

Vitamin D

Deficiency associated with:
 Rickets
 Autoimmune diseases
 Diabetes, type I
 Atopic diseases
Vitamin D

Immune issues:
 B cells
◦ Decreased proliferation
◦ Decreased immune globulin production
 T cells- Decrease in overall proliferation
◦ TH1 cytokines decreased
◦ TH2 cytokines and T regulatory cells increased
Vitamin D

Supplementation
 Sunlight (5-30 min, 2x per week)
 Foods- Fish, liver, fortified foods
(milk, cheese, OJ)
 Supplementation
 Vitamins
 Ergocalciferol (D2) or
Cholecalciferol (D3)
 Recommended: 600-800 IU
 Replenishment: 1000-4000 IU
Vitamin E

Antioxidant
◦ Protects against cell damage from free
radicals
◦ Affects innate and adaptive immunity
Vitamin E

Deficiency associated with:
 Neurologic symptoms
 Atopic disease

Immune issues:
 Loss of phagocyte responses
 T and B cell dysfunction
 Difficulty controlling viral
infections
Vitamin E

Supplementation
 Recommended: 15-30 IU/day
Omega-3 Fatty Acids

Polyunsaturated fats (PUFA)
Eicosapentaenoic acid (EPA)
Docosahexaenoic acid (DHA)
 Decreased production of inflammatory cytokines
 Increased response by white blood cells to control
inflammation
 Decrease in clotting problems, cholesterol, and
triglycerides
Omega-3/Omega-6 Ratio
Goal is to achieve a proper ratio of
w-3:w-6 of 1:4
 Supplementation

 Fish (natural ratio)
 3.5 oz piece = 1 g of w-3 FA
 Fish oil (contains both)
 1-4 g/day
Garlic
Used for both food and medicine for
thousands of years
 Allicin- exact function unknown

◦ Anti-bacterial
◦ Helps control viruses
◦ Anti-fungal

Human studies have shown shortterm, laboratory effects
Commonly promoted foods
Green tea (Camellia sinensis)
 Ginger (Zingiber officinale)
 Purple coneflower (Echinacea)
 Black cumin (Nigella sativa)
 Licorice (Glycyrrhiza glabra)
 St. John's wort (Hypericum
perforatum)

*research sparse in this area*
Probiotics

Lactobacilli, Bifidobacteria species
 Strengthen gut barrier
 Stimulate production of T cells
 Stimulate production of antibodies
 Must be ingested regularly for effects

Foods with probiotics: fermentation
Overnutrition and Obesity
Promotes inflammation
 Promotion of immune system
stimulation causing autoimmunity
 Poor wound healing
 Increased susceptibility to respiratory,
gastrointestinal, and liver infections

Summary

The best way to “boost” you immune
system is to include foods naturally
rich in nutrients and vitamins
◦ “EAT YOUR COLORS”

Oversupplementation can be
detrimental:
◦ Toxicity (Vitamin A)
◦ Inhibition of phagocytes (zinc, iron,
copper)
◦ Obesity in relation to food excess
The Brussel Sprout powerhouse
Vitamins A, C (more than an orange!), B6, folic acid, iron, selenium
References
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