There is growing evidence to promote the role of nutrition and healthy lifestyle to enhance and protect the immune system for people of all ages. While the specific level of nutrients needed across the lifespan to enhance outcomes is yet to be defined, the goal to enhance immune system development and bolster protection against pathogens is a good goal for clinicians to advance in their patients.
Epigenetic signaling and control of disease processes is becoming better understood and may soon provide clinical tools to support patient evaluation and treatment. The clinical implications of exogenous microRNA (miRNA) from a therapeutic perspective is likely just a few years away, but research has already established that dietary miRNA can be absorbed by the body. Additional research will identify modalities for clinical support of epigenetic factors that may enhance immune system development and provide clinicians with tools for intervention for health and wellness.
Who Benefits from Supporting the Immune System?
Everyone can benefit from a strong immune system to prevent illness and disease, morbidity and mortality. Nutritional components can enhance the immune system, particularly with age as processes are not as efficient as they were in the younger years.
Individuals with compromised nutritional intakes due to physical illness or poor dietary choices may benefit from nutritional interventions and supplementation to enhance outcomes and support immune health. Older individuals who are cared for in nursing homes, or the very young exposed to second hand smoke or life-long poor nutritional choices and unhealthy lifestyle, may have special needs that clinicians may recognize as candidates for nutritional intervention and support.(Meydani 2002; Meydani, Leka et al. 2004; Meydani, Barnett et al. 2007; Wu and Meydani 2008; Meydani and Hamer 2009; Barnett, Hamer et al. 2010)
How Are Special Dietary Needs Addressed?
Awareness of special needs across the life span is a critical component of nutritional evaluation by clinicians in supporting a healthy immune system. In otherwise healthy infants, a deficiency of zinc or iron may predispose children to increased morbidity, despite having normal growth. Children with picky eating behaviors may also be predisposed to deficiencies early in life that can have negative consequences when the immune system needs to mount a robust response. (Brotanek, Gosz et al. 2007; Suskind 2009; Haimi and Lerner 2014; Taylor, Northstone et al. 2016) A Mediterranean-style diet rich in omega-3 fatty acids may benefit individuals that are predisposed to metabolic syndrome and reduce the symptoms associated with being overweight, such as diabetes and cardiovascular disease.(Meydani 2005; Meydani and Azzi 2009)
Patients who are immunocompromised due to health challenges such as the HV-1 virus or are on medications that may cause immunosuppression, such as acyclovir, corticosteroids, or chemotherapy drugs may benefit from nutritional support with nutrients shown to support a healthy immune system. Individuals who are in active treatment for various cancers in which cellular immunity may be compromised would be good candidates for nutritional support. This may be particularly useful for drugs that target depletion of B cells via monoclonal antibodies as part of the immunotherapy for multiple sclerosis, cancer, and other conditions.(Baker, Marta et al.; Lehmann-Horn, Kronsbein et al. 2013; Pennock and Chow 2015; Calabresi 2017)
Individuals with compromised microbiomes or digestive disorders may find themselves more prone to immune system challenges due to an impaired epithelial/mucosal barrier or limited absorption combined with chronic inflammation. Knowledge regarding the use of antibiotic therapy and digestive health may be important factors to capture when developing an interventional approach with nutritional support and therapy. Patients recovering from surgical intervention or those with chronic wounds may benefit from a diet rich in omega-3 fatty acids, antioxidants such as vitamin A, nutrients such as arginine, zinc, and vitamin D.(Ellinger 2014; Molnar, Underdown et al. 2014; Cereda, Klersy et al. 2015; Chiang, de la Rosa et al. 2017; Serhan 2017; Serhan 2017)