Vitamin and Mineral Supplementation
Written by Sarah Cherere Obara
In biology, immunity is the balanced state of multicellular organisms having adequate biological defenses to fight infection, disease, or other unwanted biological invasion, while having adequate tolerance to avoid allergy, and autoimmune diseases. Supplementation is the use of pills or special types of food in order to improve your health.
A bidirectional relationship among nutrition, infection and immunity exists: changes in one component affect the others. Distinct immune features present during each life stage may affect the type, prevalence, and severity of infections, while poor nutrition can compromise immune function and increase infection risk.
According to the current Ministry of Health Kenya COVID-19 nutrition guidelines (MOH) nutritional management is essential to enhance immune response for an infected person against RNA viral infection such as COVID-19.
COVID-19 patients display various mild and severe symptoms and there is currently no cure for this disease. Some of the symptoms that have nutrition implications include:
- Uncomplicated illness- runny nose, fever, cough, headache, and sore throat
- Mild pneumonia-breathing difficulty, inflammation in the lungs
- Severe pneumonia
- Acute respiratory distress syndrome
- Septic shock
- Kidney failure
Nutrients are those substances or ingredients that promote growth, provide energy and maintain life they are in two groups macronutrients (needed in large amounts) and micronutrients (needed in small amounts by the body). The clinical course and outcome of certain infections such as viral and bacterial diarrhea, tuberculosis, pneumonia such as in COVID-19, and measles are predicted by the nutritional status of the individual.
Based on Centers for Disease Control those at high-risk for severe illnesses from COVID-19 are
- People 65 years and older
- People who live in a nursing home or long-term care facility
People of all ages with underlying medical conditions, particularly if not well controlled, including people:
- With chronic lung disease or moderate to severe asthma
- Who have serious heart conditions
- Who are immune-compromised (Many conditions can cause a person to be immune-compromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications).
- With severe obesity (body mass index [BMI] of 40 or higher)
- With diabetes
- With chronic kidney disease undergoing dialysis
- With liver disease
As well as pregnant women and COVID-19 health care front line workers.
What Micronutrients are Needed for The Immune System to Fight Or Prevent Disease?
- Vitamin A – deficiency causes night blindness
- Vitamin C – deficiency causes impaired wound healing
- Vitamin D- deficiency causes rickets and bone disease
- Vitamin E – deficiency causes reproductive problems
- Vitamin B2 /Riboflavin – deficiency causes inflammation of lips and tongue
- Vitamin B6/pyridoxine – deficiency causes neurological issues
- Vitamin B12/ cobalamin – deficiency causes pernicious anemia
- Folic acid – deficiency causes megaloblastic anemia
- Iron – deficiency causes Anaemia
- Selenium- deficiency causes heart disease
- Zinc– deficiency causes stunted growth
What Factors Can Influence the Micronutrient Status of a Person and Affect Immunity?
- Lack of nutritious food or certain food groups because of limited availability
- income influences ability to acquire
- Lifestyle choices such as vegetarianism or veganism) predisposes one to some deficiencies like those obtained from the animal sources
- A stressful lifestyle, often accompanied by lack of sleep and reduced physical activity increases oxidative stress
- Health conditions, such as diabetes and obesity as do genetic factors/polymorphisms such as the fat soluble vitamins
- Seasonal changes like winter can decrease vitamin D availability
- sweating in hot countries or during exercise one may lose Iron, Zinc
- Increased Energy expenditure utilizes stored micronutrients mainly of B vitamins and C
- Air pollution reduces vitamins such as Vitamin D
- Body exposure to pathogens loses micronutrients as it works more to fight
- Social, cultural , ethnic factors influence diet and hence the micronutrient status
Adequate micronutrient intake is essential to aid recovery from infection, this intake can be made more difficult by the fact that food intake may decrease during illness. Antibiotic use can also deplete certain micronutrients hence however much we get from diet should be complemented by supplementation.
It is recognized that micronutrient deficiencies and suboptimal intakes are common worldwide. This can affect the risk and severity of infection, and lead to malnutrition. Consequently this will predict the clinical course and outcome of certain infections such as diarrhea, pneumonia and measles.
It should be noted that the source of the micronutrient should be considered (i.e., dietary versus supplements), some nutrients are more available from natural foods and some from supplements. There are the various factors that affect the bioavailability of the micronutrient and their efficacy.
Diet alone is not sufficient to ensure adequate nutrient intake due to the factors discussed above.
What are the Clinical Benefits of Supplementation?
- Reducing disease duration
- Increased resistance to infections
- optimize immune function including improving defense function
It has been noted that limited success in achieved in supplementation if one tackles one micronutrient at a time because these nutritional deficiencies occur together. It is also worthwhile to note that the immune system utilizes a variety of micronutrients to achieve maximum function. Hence theres is justification to do multiple micronutrient supplementation.
Caution: Food Supplements Must Not Replace a Varied and Balanced Diet and a Healthy Lifestyle.
Nutritional management of Disease is a complex and individualized process and therefore one should consult with a Licensed and Practicing Dietitian/Nutritionist for Individualized care based on current disease state and other factors such as gender, weight, height and even level of activity.
Basic components of the immune system
Sarah Cherere Obara is a Clinical Nutrition/Dietetics Specialist KNH and currently a PHD Student and Tutorial Fellow in the Department of Food Science Nutrition and Technology of the University of Nairobi-Kenya
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