The roles of micronutrients in your immune function explained

immune vitamins

Your immunes system has an elaborate army of warriors that defend you against vicious pathogens. There are specialized immune cells, physical and chemical barriers, as well as antibodies that can specifically tackle familiar pathogens. However, when it comes to brand new enemies like the novel coronavirus, COVID-19, even this intricate system can fail.coronavirus

Every stage of the immune response is heavily dependent on the presence of micronutrients, including essential vitamins and trace minerals. “Micronutrient malnutrition” is when there are deficiencies and negative consequences on the body’s ability to combat infections. Unfortunately, micronutrient deficiencies are common worldwide, including industrialized countries. So we recommend that you regularly check in your micronutrient levels with a blood test and add supplements if needed.

Elderly people, children, immunocompromised people are among the high-risk populations amid COVID-19 crisis. They are also the ones that are most susceptible to micronutrient malnutrition and week immune systems. The Harvard Medical School notes that respiratory infections and particularly pneumonia are a leading cause of death in people aged over 65, calling for preventative micronutrient supplementations.

After reviewing the latest reviews of immune-boosting micronutrients published on the prestigious journals Nutrients and Frontiers in Immunology, we recommend adequate consumption of:

  • Essential Vitamins: vitamin A, B6, B9, B12, C, D, E
  • Minerals: Zinc, Iron, Copper, Selenium
  • Probiotics

Vitamins are natural compounds that carry out important biochemical functions in the body. If their concentration is reduced due to insufficient dietary intake, there can be a number of health consequences, especially weakened immunity. Albert Szent-Gyorgyi, the Nobel laureate for Physiology and Medicine, puts it this way: “A vitamin is a substance that makes you ill if you don’t eat it.”1

blueberries

Vitamin A

Vitamin A is known as an “anti-inflammation vitamin” due to its diverse roles in enhancing immune function.2 It is an integral part of the respiratory tract by promoting mucus secretion, thereby improving barrier function against infectious disease.

In addition, vitamin A is essential for the proliferation, maturation and aggregation of immune cells. Innate immune cells such as macrophages and neutrophils initiate immediate responses to an acute infection by engulfing infected cells. Vitamin A is indispensable for the production of these cells.

After the initial immune response driven by innate immunity, adaptive immune responses mediated by T cells kick in. Vitamin A continues to be an essential player by mediating T cell production, migration and its homeostasis in ongoing immune responses.

Vitamin A deficiency is closely related to infectious disease such as tuberculosis, HIV, measles and acute pneumonia. The World Health Organization (WHO) regards vitamin A deficiency as a serious public health concern for increasing the risks of mortality from infectious diseases.3 Supplementing vitamin A has demonstrated an effective therapeutic effect and is therefore recommended by the WHO.

Vitamin B complex

Vitamin B is not a single vitamin but consists of several different compounds including vitamin B1, B2, B3, B5, B6, B7, B9 and B12. Several members play important roles in boosting immune functions, namely B6, B9 and B12.

Vitamin B6 is indispensable in the differentiation and maturation of white blood cells. Even marginal deficiency has been shown to impair antibody production, and the ability to respond to infectious challenge.4 Moderate supplementation helps to restore immunity and improve the available numbers of T cells. A higher dose of supplementation has been shown to improve immune response in critically ill patients.

Vitamin B9 is also commonly known as folate, an essential supplement for pregnant women. It maintains and enhances natural killer cell activity as well as antibody production.4 Deficiency can lead to an overall impaired immune response. Folate supplementation has been shown to increase innate immunity in elderly people.

Vitamin B12 is involved in fundamental metabolism in every cell of the human body, regulating DNA synthesis and T cell replication. Vitamin B12 deficiency is known to reduce immune response during viral and bacterial infections, partly by suppressing natural killer cell activity.5 Fortunately, supplementation has been shown to restore these adverse effects and are recommended amid coronavirus crisis.4

Vitamin C

Vitamin C is an essential micronutrient that cannot be synthesized or stored by the human body. As a result, daily intake of Vitamin C from your diet or supplementation is critical.

As a cofactor for a battery of gene regulatory enzymes, Vitamin C has multifaceted functions ranging from epithelial barrier protection against pathogens to overcoming oxidative stress.6

vitamin c

Source: Vitamin C and Immune Function, Carr & Maggini, Nutrients

Vitamin C deficiency is known to result in higher susceptibility to infections. In turn, infections further exhaust vitamin C due to enhanced inflammation and metabolic requirements.

A wealth of scientific studies has supported the supplementation with vitamin C to prevent and treat respiratory and systematic infections. In a systematic review of Vitamin C and immune function, the authors concluded that: “Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels (i.e., 100–200 mg/day), which optimize cell and tissue levels.” If someone already has an infection, significantly higher doses of Vitamin C will be required to compensate for the increased metabolic demand imposed by the inflammatory response.

Vitamin D

Vitamin D3 is the most physiologically relevant form of vitamin D. It is synthesized in the skin in a process that requires sunlight. Unfortunately, many people are deficient in vitamin D due to inadequate sun exposure and requires supplementation.forest

Vitamin D is best known for calcium and bone homeostasis. However, it also acts on both innate and adaptive immune cells, including macrophages, dendritic cells, T and B lymphocytes.7 In fact, vitamin D was used to treat infections like tuberculosis before the advent of antibiotics.

Deficiency in vitamin D can lead to increased susceptibility to infections. A study of 19,000 subjects with lower vitamin D levels showed a higher likelihood of upper respiratory tract infection.8 Since COVID-19 is also a respiratory infectious disease, it is likely that those with lower vitamin D levels may have an immune disadvantage.

Vitamin E

Vitamin E is a potent antioxidant that can protect cells from damages caused by oxidation. Notably, immune cells usually contain higher levels of vitamin E due to higher demand. There is a clear link between vitamin E deficiency and impaired immune function. Growing evidence also suggests that the current dietary guideline for vitamin E is inadequate.9

Supplementation has been shown to enhance proliferation of white blood cells, improve antibody levels and natural killer cell activity.10 A systematic review of scientific evidence supports the immunostimulatory effects of vitamin E in resisting infections such as pneumonia.

Zinc

Zinc is an essential trace mineral that is required for both innate and adaptive immune functions. An estimate of 30% of the world’s population has zinc deficiency. These individuals are likely to have reduced white blood cell proliferation, antibody response, natural killer cell and macrophage cell activity.9

Multiple studies have shown that supplementation with zinc can effectively reverses these impairments. It can reduce respiratory tract infections and mortality from infectious diseases. Several high-quality clinical trails have shown that zinc supplementation can protect children and the elderly population from common colds and pneumonia.

Copper

Copper accumulates in macrophages, the cells that engulf infectious agents. Copper also has antimicrobial properties that help destroy a range of invading microorganisms.4 In addition, copper can catalyze the formation of reactive oxygen species that are toxic to pathogens.

People who are deficient in copper have abnormally low neutrophil levels and reduced ability to engulf pathogens. Moderate supplementation can effective restore its function, but excessive supplementation can also be detrimental.

Iron

Iron has many critical functions in the body, including oxygen transport and fighting pathogens. For example, neutrophils require iron to generate reactive oxygen species for killing pathogens.4 T lymphocyte proliferation and cytokine production also require iron.

Iron deficiency supresses immune responses, leading to a reduced resistance to respiratory tract infection in children. Iron supplementation can effectively improve microbial killing and clearing of the infection.

vege iron

Selenium

Similar to copper and iron, selenium is also important for the proliferation of immunes cells, antibody production, and overall immunity.4 Its deficiency disrupts a number of cellular processes required for maximal immune response and increases the risk of respiratory tract infections in children. Supplementation has been shown to improve immune cell counts and enhance the immune response to viruses.

Probiotics

Probiotics are live microorganisms that improve gut flora and subsequently other body functions such as better immunity. The most known genera of probiotic supplements included Lactobacillus and Bifidobacterium.

Apart from improving the physical gut barrier function, probiotics can also induce anti-inflammatory cytokines, promote T and B cell functions.9 These benefits can enhance resistance against respiratory and gastrointestinal infections.

gut health

Summary

In summary, micronutrients need to be maintained at optimal levels for acute establishment as well as maintenance of immune responses. If you can, get a blood test and see if you are deficient in any micronutrient. Eat a well-balanced diet with plenty of fruits and vegetables, and supplement with immune-supportive micronutrients if needed.

Apart from these supplements, a good lifestyle is also essential. Make sure that you also:

  • Clean your hands
  • Get enough sleep
  • Manage your stress
  • Work out regularly

lifestyle

Online consultations available with accredited practising dietitian

To improve your immune functions, it is critical that you continue healthy habits including drinking plenty of water, good nutrition, sleep, and exercise.

We are here to provide knowledge on nutrition during this special period of time via online consultations. Please don’t hesitate to reach out for help! We are in it together.

lifestyle coronavirus

You can meet our plant-based, vegan dietitian Raymond here.

References

1            Mora, J. R., Iwata, M. & von Andrian, U. H. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol 8, 685-698, doi:10.1038/nri2378 (2008).

2            Huang, Z., Liu, Y., Qi, G., Brand, D. & Zheng, S. G. Role of Vitamin A in the Immune System. J Clin Med 7, doi:10.3390/jcm7090258 (2018).

3            Muhammad Farhan Aslam, S. M., Sidra Aslam, Jazib Ali Irfan. Vitamins: Key Role Players in Boosting Up Immune Response-A Mini Review. Vitamins & Minerals 6, doi:10.4172/2376-1318.1000153 (2017).

4            Gombart, A. F., Pierre, A. & Maggini, S. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients 12, doi:10.3390/nu12010236 (2020).

5            Tamura, J. et al. Immunomodulation by vitamin B12: augmentation of CD8+ T lymphocytes and natural killer (NK) cell activity in vitamin B12-deficient patients by methyl-B12 treatment. Clin Exp Immunol 116, 28-32, doi:10.1046/j.1365-2249.1999.00870.x (1999).

6            Carr, A. C. & Maggini, S. Vitamin C and Immune Function. Nutrients 9, doi:10.3390/nu9111211 (2017).

7            Aranow, C. Vitamin D and the immune system. J Investig Med 59, 881-886, doi:10.2310/JIM.0b013e31821b8755 (2011).

8            Ginde, A. A., Mansbach, J. M. & Camargo, C. A., Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med 169, 384-390, doi:10.1001/archinternmed.2008.560 (2009).

9            Wu, D., Lewis, E. D., Pae, M. & Meydani, S. N. Nutritional Modulation of Immune Function: Analysis of Evidence, Mechanisms, and Clinical Relevance. Front Immunol 9, 3160, doi:10.3389/fimmu.2018.03160 (2018).

10          Lee, G. Y. & Han, S. N. The Role of Vitamin E in Immunity. Nutrients 10, doi:10.3390/nu10111614 (2018).

Top 5 Things You Need To Know About Gut Health

All diseases begin in the gut

Normally, we are very superficial and we tend to concern ourselves more when we have external problems, rather than internal problems. For example, wouldn’t you be more scared that you scarred your face rather than having poor gut health?

 

It’s funny when you think about it. We got it the wrong way, it is so much more important to take care of our inner organs which will help the maintenance and recovery of our whole body.

 

How much effort have you put in to take care of your GUT (Gastrointestinal tract)? Our gut compared to everything else in the body ‘combined’, has 10 times the amount of cells. Can you believe that?

 

That’s HUGE. If that isn’t a sign that we need to take care of this super factory that we have inside of us. I don’t know what is.  

 

Why is our Gut Bacteria crucial for our well being?

 

The importance of gut health has long been realised. Hippocrates, the Father of Modern Medicine once said “All diseases begin in the gut!”

 

Now, latest research studies have shown that not only is our gut linked to diseases, it is even connected to our brain, hence the name given to our gut “The second brain“. Wow, HOW IS THIS POSSIBLE?? 

GUT-BRAIN AXIS – Microbially-produced neurotransmitters and other metabolites reach the brain directly through the vagus nerve!

 

This means that who we are, how we react, and how we feel are dependent by the quality of bacteria in our gut? Yes, kind of.

 

Dr. Michael Gregor has some really nice evidence based videos on how we can improve mood through diet. I highly recommend that you check them out after reading this blog. But the good news is – Vegetarians and vegans have significantly better depression, anxiety, stress scale. In other words, plant powered people are happier!

 

If you want to indulge in a philosophical thought for a moment, think about – are we really in control of ourselves, or are our gut microbes more in control of us?

 

Fancy that as a conversation topic over coffee. 

 

Getting back to the point of the article, the gut is the most amazing thing ever! This led me to pay $350 to test my own microbiome by giving a local company called Microba my stool sample.

 

I received my test results, i booked a consultation with a Dietitian (why not learn from others in the same profession right, always intrigued by how other dietitians talk the talk), to find out the practical tips of what I can do to improve my microbiota.

 

The Top 5 Things You Need To Know About Your Gut Bacteria

 

If you are a video person, here is a short video with an overview of the following 5 points 

5 Things You Need to Know About Gut Health – 2018 Edition

 

Number 1 – Microbial composition during early development is crucial

 

We used to think that the uterus and fetus are sterile, and the first time a baby encounters any microbes is upon birth. Increasing evidence on suggest that human microbiota is seeded before birth.

 

After birth, the microbial diversity increases dramatically. Because of this initial colonisation of microbiota runs in parallel with immune system maturation and brain development, the first 1000 days are considered critical for a newborn.

 

After the baby is weaned and starts eating food, this is when the microbiota converges toward an adult-like microbiota. By 3-5 years old, the composition of the gut microbiota resembles that of an adult and is relatively stable thereafter.

 

Alteration in the development of the gut microbiota of a newborn has been demonstrated to predispose to diseases later in life in a few studies. Although we are waiting for more research to uncover the full effect of initial microbiota development, it can be agreed upon that setting up a good initial gut ecosystem during the first 1000 days is critical.

 

If you are reading this post, you have past the age of altering the initial microbial colonisation (sorry!). We’ll get to how you can still improve it with lifestyle later. But now, how can you set up a good initial gut ecosystem for your babies?

 

Number 2 – Setting up a good initial gut ecosystem

 

To ensure a good initial microbial colonisation process, the mum plays the most important role (oh pressure, ladies).

 

The major factors that contribute to microbial colonisation include

  • Maternal microbiota
  • Mode of birth
  • Feeding
  • Preterm birth
  • Antibiotic treatment.

 

Maternal microbiota

We are at a very exciting time. It is only recently that scientists discovered microbial genes in the placenta, which suggests the possibility of maternal-offspring exchange of microbiota.

 

We still know very little about the microbes that traverse the placenta, whether they persist in the infant and what roles they play exactly. Nevertheless, ladies should aim to have a high quality gut microbiota before and during pregnancy.

Mode of birth

The first major microbial exposure occurs during birth. Naturally born infants are colonised by the vaginal and fecal bacteria coming from the mother. Infants born via C-section are instead colonised with microbes associated with the skin and the hospital environment.

 

It is suggested that the microbiota composition in these infants may remain disturbed for months or even years. So it is crucial that if a baby has to be born via C-section, he or she gets a vaginal swab to mimic the birth canal environment.

 

Feeding

A major source for bacterial colonisation of the infant gut is through bacteria in the mother’s milk, and it has been proposed that this mode of colonisation plays a major role in the child’s health status.

 

The milk microbiota is reported to contain more than 700 species of bacteria and an abundance of complex oligosaccharides with prebiotic activity, stimulating the growth of specific bacterial groups.

 

Therefore, it is highly recommended that mums try to breastfeed newborns to provide the best support of infant microbial colonisation. If breastfeeding is not possible, choosing the right formula becomes important. Nowadays, some formula companies are taking into consideration the critical gut colonisation process and are trying to mimic the breast milk by adding pre- and probiotics. It is encouraged that mums choose such formula as well as provide newborns with additional pre- and probiotic supplementation.

 

Pre-term birth

This might sound scary, but in preterm infants, the microbiota is characterized by reduced diversity and higher levels of potentially pathogenic bacteria compared with full-term infants.

 

Therefore, pre-term babies need extra care. Breastfeeding is highly encouraged, so are additional pre- and probiotic supplementation.

 

Antibiotic treatment 

Antibiotic treatment can dramatically disturb an adult’s gut environment, let alone a fragile newborn. Even short-term antibiotic treatment can significantly affect the development of the infant gut microbiota.

 

As a result, antibiotic treatment should be avoided as much as possible. If necessary, make sure the baby get plenty of breast milk and additional pre- and probiotic supplementation.

 

I thought you might be scared at this point, but don’t be! Try your best to prevent and restore the gut ecosystem for your baby by using the following guidelines!

 

influence microbiota development

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4464665/

 

Number 3 – Are Pro-biotics Effective?

 

Well, you’re either going to love me or hate me with this next part I’m going to say. Unless you have been sick for a very long time, or had a long streak of antibiotics, or have irritable bowel syndromes such as bloating, diarrhea, constipation or gas, probiotic supplements for the healthy people out there could be a waste of money.

 

Here’s why.

 

1. Most bacterial strains are likely dead by the time we ingest them due to long/inappropriate storage before purchase. 

 

2. Most of the probiotics don’t even make it down there, and even if it did, it is very hard for our gut ecosystem to accept new strands of bacteria and stay.

As a result, the effects of probiotics are most often transient. Remember what was said before, the gut microbiota is relatively stable after 3-5 years old. Unless you take probiotics on a daily basis, the new bacterial strains are unlikely to stay in your gut.

 

Number 4 – How to improve your gut health?

 

Once the gut microbiota is established after 3-5 years old, the composition is relatively stable throughout adult life, but, BUT

 

The gut environment can be still be altered as a result of bacterial infections, antibiotic treatment, lifestyle, surgical, and a long-term change in diet.

 

So save your money, and work on your diet and lifestyle instead!

 

The best way to grow healthy bacteria is to eat plant-based fibres. Dietary fibres are the preferred fuel for healthy bacteria and they often serve as beneficial natural prebiotics! No need to spend money when you can get it from nature!

 

In return, the healthy bacteria thriving on the plant fuel happily produce short-chain fatty acid and protect against allergic inflammation, heart diseases, and so on.

 

What’s the best way of getting lots of dietary fibre?

 

Eat a variety of whole foods from core food groups (whole grains, fruits, vegetables, legumes, nuts and seeds). Most importantly, choose different colours, aim for a beautiful food palette! If you don’t know yet, this is the reason that we are called Vegan PaletteEating a variety of colourful foods is our philosophy!

Vegan Palette's guide to healthy vegan diet

 

Number 5 –  High bacterial richness – What? Why? How?


Lastly, you want aim for a high gut bacterial richness. Let me explain why.

 

Studies found that people tend to fall into one of two groups:

High gut “bacterial richness” group: those with a variety of types of gut bacteria

Low gut “bacterial richness” group: those with a few types of gut bacteria

 

What’s the difference?

 

Compared to high bacterial richness individuals, those with low bacterial richness have more body fat, insulin resistance and increased likelihood of developing type 2 diabetes, as well as higher levels of inflammatory markers.

 

How do make sure you are in the high gut “bacterial richness” group?

 

Simple – increase our fruit and vegetable intake. This seemingly simple approach has been associated with high bacterial richness in a number of studies.

 

Don’t try to take a shortcut by just taking fibre-containing supplements because they don’t seem to increase richness! The complexity of whole foods such as grains could support a variety of bacterial types, increasing our gut bacterial richness. Remember, real foods don’t just contain fibre, but a variety of beneficial phytonutrients!

 

By the way, Dr. Michael Gregor from Nutritionfacts.org has an in-depth video explaining the original research that showed how whole grains can increase our gut bacterial richness! I recommend you watch it later – Gut microbiome – Strike it rich with whole grains.

 

This is important because your body will perform at the lowest level of healthy bacteria, and not fully utilising the capabilities of the bacteria with high strands. It’s like playing footy, New Zealand is one of the best teams because all the players work together. It is the same with our gut, we need our healthy bacteria to work together, and to do that, we need an even spread of healthy bacteria, not too much and not too little. 

 

Conclusion

There you have it. How important it is to take care of gut, from before birth to every single day of our adult life! The big and small decisions we make, determine how healthy our gut is. We are what we eat! 

 

As a final reminder, keep this timeline in mind!

microbiota development

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315782/

 

Thank you for reading all this, we hope it has helped you understand how you can take better care of the gut microbiota from today. We’ll leave you with an inspirational quote:

“The biggest influence you can have on the state of your gut lining, and a healthy microbiome, is your diet—which you control.” Jeannette Hyde

 

Let us know how your gut health journey goes from here. Comment below what you liked about this article, and what topic you would like us to cover next! 

 

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References

Mueller NT, Bakacs E,Combellick J, Grigoryan Z, Dominguez-Bello MG. (2015). The infant microbiome development: mom matters. Trends in Molecular Medicine. 21(2):109-117. doi:10.1016/j.molmed.2014.12.002.

Goldsmith F, O’Sullivan A, Smilowitz JT & Freeman SL. Lactation and Intestinal Microbiota: How Early Diet Shapes the Infant Gut. Journal of Mammary (2015). Gland Biology and Neoplasia. 20 (3-4): 149-58. doi: 10.1007/s10911-015-9335-2.

Rodríguez JM, Murphy K, Stanton C, et al. (2015). The composition of the gut microbiota throughout life, with an emphasis on early life. Microbial Ecology in Health and Disease. 26:10.3402/mehd.v26.26050. doi:10.3402/mehd.v26.26050.

Sharon, G., Garg, N., Debelius, J., Knight, R., Dorrestein, P. C., & Mazmanian, S. K. (2014). Specialized metabolites from the microbiome in health and disease. Cell Metabolism, 20(5), 719–730. http://doi.org/10.1016/j.cmet.2014.10.016

Timothy G. Dinan, Roman M. Stilling, Catherine Stanton & John F. Cryan. (2015). Collective unconscious: How gut microbes shape human behavior. Journal of Psychiatric Research, 63: 1- 9. https://doi.org/10.1016/j.jpsychires.2015.02.021

 

About the author


Raymond_dietitian_from_Vegan_Palette_with_food_plate

Raymond Setiadi is an Australian Accredited Practising Dietitian and is the founder of Vegan Palette,  a Brisbane-based dietitian practice.

As an expert in whole food plant-based nutrition and fat loss strategies, Raymond has a comprehensive understanding of the interplay between food,  human physiology, goal-directed psychology, and how they all play a pivotal role in one’s pursuit of optimal health.