Your Mother Was

Right-

you 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.

Sistem imun

Diakuisisi

Asli

Sel T

Sel B

Antigen

Antigen

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 g/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

of 1:4
Supplementation
Fish (natural ratio)
3.5 oz piece = 1 g of 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

detrimental:

can be

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

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