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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